83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS-USCIS

0091
1615
___ ___
___ ___ - ___
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Enter only items that change
Current record

New record

Agency form number (s)

N-565

Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%

Total annual hours
Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

USCIS is requesting OMB approval of a non-substantive change to update the form and instructions to comply with Executive
Order 14168, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal
Government. N-565 must be revised to remove the ability to request a change of gender on a secured document. Applicants
can only request a document correction.
Signature of Senior Official or designee:
Date:
For OIRA Use
___________________________________
Digitally signed by JOHN R
JOHN R
RAMSAY JR
___________________________________
3/14/2025
Date: 2025.03.14 13:41:28

RAMSAY JR

-04'00'

** This form cannot be used to extend an expiration date.

OMB 83-C

10/95