View Information Collection (IC)

View Information Collection (IC)

IC Title:	Office of Refugee Resettlement Waiver Request Form	Agency IC Tracking Number:	ORR

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Request Form			Waiver Request Form__06252021.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 235	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	470	0	470	0	0	0
Annual IC Time Burden (Hours)	141	0	141	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Generic Monitoring Activities Submission Form - ORR Waiver Request Form	Monitoring Generic_0970-0558 - ORR Waiver Request FINAL 06.30.21.docx	07/01/2021
ORR Waiver Request Procedures	ORR Waiver Request Procedures__06252021.docx	07/01/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.