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: 1405-0234	ICR Reference No: 202006-1405-001
Status: Historical Inactive	Previous ICR Reference No: 202002-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Public Charge Questionnaire
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 08/06/2020
	Date Received in OIRA: 06/03/2020
Terms of Clearance: Because of the preliminary injunction that was issued against the Department in the Southern District of New York (Make the Road New York, et al. v. Pompeo et al.), the Department of State wishes to withdraw the certifications under 5 CFR part 1320 for this information collection, which were submitted on June 3, 2020 and February 2, 2020.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved	08/31/2020
Responses	0	0	397,814
Time Burden (Hours)	0	0	1,790,163
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $5,000,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Ari Attar 202 485-7638

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