Information Collection Request

[NCEZID] Statement in Support of Application for Waiver of Inadmissibility Under Immigration and Nationality Act

ICR 202401-0920-001 · OMB 0920-0006 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0006 can be found here:

Forms and Documents

Document Name	Status
Form 4.422-1 Application for Waiver of Inadmissibility Under Immigration and Nationality Act (Form 4-422-1) Form and Instruction	Modified
Attachment F Privacy Impact Assessment.pdf Supplementary Document	2024-01-17
Attachment D Human Research Determination.pdf Supplementary Document	2024-01-02
Supporting Statement B 2023.docx Supporting Statement B	2024-01-17
Supporting Statement A 2023.docx Supporting Statement A	2024-01-17
Attachment A3 8 CFR 212.7 Waiver of certain grounds of excludability.pdf Supplementary Document	2024-01-17
Attachment A2 42 CFR Part 34 Medical Examination of Aliens.pdf Supplementary Document	2024-01-17
Attachment A1 8 USC 1182.pdf Supplementary Document	2024-01-17

IC Document Collections

IC ID	Document Title	Status
6595	Application for Waiver of Inadmissibility Under Immigration and Nationality Act (Form 4-422-1) Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-0006
Type of Information Collection	Reinstatement with change of a previously approved collection
Previous ICR Reference No	202006-0920-005
Agency Tracking No	0920-0006
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31