Application for Employment Authorization

Forms and Documents

Document Name	Status
Form I-765WS Work Sheet Form	Modified
I-765,I-765WS 30-day PUBLISHED notice.2.27.13.pdf Supplementary Document	2013-02-27
I-765,I-765WS 60-day PUBLISHED notice.12.17.12.pdf Supplementary Document	2013-02-27
I765WS-TOC-FRM-02152013.docx Supplementary Document	2013-02-26
I765-TOC-INS-30Day-02152013.docx Supplementary Document	2013-02-26
I765-TOC-FRM-30Day-02152013.docx Supplementary Document	2013-02-26
DACA Response to I-765WS Public Comments 021513.docx Supplementary Document	2013-02-26
DACA Response to I-765 Public Comments 021513.docx Supplementary Document	2013-02-26
I765-INS-TOC-OMBReview-08152012(H4).doc Supplementary Document	2012-12-12
I-765 SUPPORTING STATEMENT.FINAL.docx Supporting Statement A	2013-03-28
NPRM.Place Holder.docx Supplementary Document	2012-12-12
Federal Register, Volume 75 Issue 2 (Tuesday, January 5, 2010).mht Supplementary Document	2012-08-10
Federal Register, Volume 76 Issue 113 (Monday, June 13, 2011).mht Supplementary Document	2012-08-10
Federal Register, Volume 73 Issue 189 (Monday, September 29, 2008).mht Supplementary Document	2012-08-10
privacy_pia_cis_claims3.pdf Supplementary Document	2012-08-10
Reference citation.doc Supplementary Document	2011-09-01

IC Document Collections

IC ID	Document Title	Status
203680	Passport-Style Photographs	Modified
203678	Work Sheet Form	Modified
203677	Biometric Processing	Modified
20321	Application for Employment Authorization Instruction	Modified

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201212-1615-001
Status: Historical Active	Previous ICR Reference No: 201208-1615-002
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: 04/01/2013
	Date Received in OIRA: 12/14/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved	03/31/2013
Responses	4,590,049	0	5,955,249
Time Burden (Hours)	7,140,900	0	9,048,767
Cost Burden (Dollars)	14,200,000	0	0

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Abstract: The information will be used by the USCIS to determine eligibility for work authorization and for the issuance of the 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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 74687	12/17/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 13368	02/27/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

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

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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	4,590,049	5,955,249	0	0	-1,365,200	0
Annual Time Burden (Hours)	7,140,900	9,048,767	0	0	-1,907,867	0
Annual Cost Burden (Dollars)	14,200,000	0	0	14,200,000	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There has been a decrease on the burden hours associated with this collection since the last request USCIS submitted to OMB. USCIS last submitted an emergency request to OMB seeking the approval of a total of 9,048,767 burden hours in connection with this information collection. With this submission, USCIS is seeking the approval of only 7,140,900 burden hours. The decrease in burden hours is due to the agency's better estimates with regard to the number of respondents.

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Annual Cost to Federal Government: $628,339,320

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: 12/14/2012

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