Application for Employment Authorization

Forms and Documents

Document Name	Status
Form I-765WS Work Sheet Form	Modified
Form I-765 Application for Employment Authorization Form	Modified
Form I-765 Supporting Statement H-4 FR. FINAL.docx Supporting Statement A	2015-02-13
privacy_pia_cis_claims3.pdf Supplementary Document	2015-02-05
Federal Register, Volume 76 Issue 113 (Monday, June 13, 2011).mht Supplementary Document	2015-02-05
Federal Register, Volume 75 Issue 2 (Tuesday, January 5, 2010).mht Supplementary Document	2015-02-04
Federal Register, Volume 73 Issue 189 (Monday, September 29, 2008).mht Supplementary Document	2015-02-04
Reference citation.doc Supplementary Document	2015-02-04
I765-INS-TOC-OMB-H4-02132015.docx Supplementary Document	2015-02-13
I765-FRM-TOC-OMB-H4-02132015.docx Supplementary Document	2015-02-13

IC Document Collections

IC ID	Document Title	Status
214873	I-765 e-Filing Other-screenshots e-filing	New
203680	Passport-Style Photographs	Modified
203678	Work Sheet Form	Modified
203677	Biometric Processing	Modified
20321	Application for Employment Authorization Form	Modified

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201502-1615-004
Status: Historical Active	Previous ICR Reference No: 201407-1615-003
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-765, I-765WS
Title: Application for Employment Authorization
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/13/2015
	Date Received in OIRA: 02/06/2015
Terms of Clearance: USCIS may begin using the new instruments no earlier than the effective date of the Employment Authorization for Certain H-4 Dependent Spouses (1615-AB92) Final Rule.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2018	36 Months From Approved	04/30/2016
Responses	4,463,032	0	4,590,049
Time Burden (Hours)	8,159,070	0	7,140,900
Cost Burden (Dollars)	602,380,864	0	14,200,000

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Abstract: USCIS will use the information collected to determine eligibility for work authorization and for the issuance of an employment authorization document.

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Authorizing Statute(s): US Code: 8 USC 1153 Name of Law: Immigration Nationality Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1615-AB92	Final or interim final rulemaking	80 FR 11111	02/04/2015

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Application for Employment Authorization	I-765	Application for Employment Authorization Document
Biometric Processing
Work Sheet	I-765WS	Form I-765 Work Sheet
Passport-Style Photographs
I-765 e-Filing

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,463,032	4,590,049	0	1,123,032	-1,250,049	0
Annual Time Burden (Hours)	8,159,070	7,140,900	0	2,175,170	-1,157,000	0
Annual Cost Burden (Dollars)	602,380,864	14,200,000	0	36,159,114	552,021,750	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The current hour inventory approved for this form is 7,140,900 hours, and the requested new total hour burden is 8,159,070, which is an increase of 1,018,170 annual burden hours. The estimate for the total number of I-765 respondents is 1,981,516 respondents. USCIS is now reporting new estimates with regard to the number of I-765 respondents and also the new population (117,300 respondents) the final rule discussed in this supporting statement projects would request H-4 based employment authorization. In addition, USCIS is also now reporting the burden associated with the electronic filings of requests for EADs (329,334 burden hours).

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Annual Cost to Federal Government: $774,226,080

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/06/2015

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