View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1615-0033	ICR Reference No: 200504-1615-002
Status: Historical Inactive	Previous ICR Reference No: 200303-1615-035
Agency/Subagency: DHS/USCIS	Agency Tracking No:
Title: Medical Examination of Aliens Seeking Adjustment of Status
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 05/10/2005
	Date Received in OIRA: 04/29/2005
Terms of Clearance: Improperly submitted. DHS must resubmit this information collection request with a revised form endorsed, with appropriate letterhead, by the Department of Homeland Security. The revised form will also include an expiration date.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2005	05/31/2008	05/31/2005
Responses	800,000	0	800,000
Time Burden (Hours)	1,200,000	0	0
Cost Burden (Dollars)	0	0	0

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