Instructions For Report Of Medical Examination And Vaccination Record Page 12

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ROUTINE USES: DHS may share the information you and the civil surgeon provide on this form with other Federal,
state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described
in the associated published system of records notices [DHS/USCIS-007 - Benefits Information System and
DHS/USCIS-001 - Alien File, Index, and National File Tracking System of Records] which you can find at
DHS may also share the information, as appropriate, for law enforcement purposes or in the
interest of national security.
Paperwork Reduction Act
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection
of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public
reporting burden for this collection of information is estimated at 2 hours and 30 minutes per response, including the
time for reviewing instructions, gathering the required documentation and information, completing the form, preparing
statements, attaching necessary documentation, and submitting the form. Send comments regarding this burden estimate
or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship
and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW,
Washington, DC 20529-2140; OMB No. 1615-0033. Do not mail your completed Form I-693 to this address.
Form I-693 Instructions 02/07/17 N
Page 12 of 12

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