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OMB Control No: 1615-0114	ICR Reference No: 202608-1615-006
Status: Received in OIRA	Previous ICR Reference No: 202401-1615-022
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-910
Title: Application for Civil Surgeon Designation
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 09/24/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2027
Responses	470	470
Time Burden (Hours)	854	854
Cost Burden (Dollars)	24,205	24,205

Annual Cost to Federal Government: $465,300

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. Yes

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: Josue Chahin 202 817-4156 josue.e.chahin@uscis.dhs.gov

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