Application for Advance Permission to Return to Unrelinquished Domicile

ICR 199612-1115-001

OMB: 1115-0032

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1115-0032 199612-1115-001
Historical Active 199311-1115-005
DOJ/INS
Application for Advance Permission to Return to Unrelinquished Domicile
Extension without change of a currently approved collection   No
Regular
Approved without change 02/04/1997
Retrieve Notice of Action (NOA) 12/03/1996
Approved; INS request to not display the expiration date on the form is approved. Upon reprinting the form, INS shall add the required PRA burden statement and disclosure statement to the form. This approval is contingent upon INS providing additional information on the utility of the employment and immediate family information which is currently required. If INS determines the information is no longer required, they may submit an Information Correction Worksheet with the revised form.
  Inventory as of this Action Requested Previously Approved
02/29/2000 02/29/2000 02/28/1997
300 0 300
75 0 75
27,000 0 0

Information collected on this form will be used by the Service to determine whether an applicant is eligible for discretionary relief under section 212(c) of the Act.

None
None


No

1
IC Title Form No. Form Name
Application for Advance Permission to Return to Unrelinquished Domicile I-191

  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 300 300 0 0 0 0
Annual Time Burden (Hours) 75 75 0 0 0 0
Annual Cost Burden (Dollars) 27,000 0 0 27,000 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/03/1996


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