Application to Register Permanent Residence or Adjust Status, and Supplement A to Form I-485

ICR 200005-1115-005

OMB: 1115-0053

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1115-0053 200005-1115-005
Historical Active 199909-1115-005
DOJ/INS
Application to Register Permanent Residence or Adjust Status, and Supplement A to Form I-485
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 06/22/2000
Retrieve Notice of Action (NOA) 05/19/2000
  Inventory as of this Action Requested Previously Approved
06/30/2001 06/30/2001
523,028 0 0
2,417,256 0 0
152,109,000 0 0

This information will be used to request and determine eligibility for adjustment of permanent residence status. This application allows an applicant to determine whether he or she must file under section 245 of the iNA, and it allows the Service to collect information needed for reports to be made to different government committees.

None
None


No

1
IC Title Form No. Form Name
Application to Register Permanent Residence or Adjust Status, and Supplement A to Form I-485 I-485, SUPP.A-I-485

  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 523,028 0 0 523,028 0 0
Annual Time Burden (Hours) 2,417,256 0 0 2,417,256 0 0
Annual Cost Burden (Dollars) 152,109,000 0 0 152,109,000 0 0
Yes
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.
05/19/2000


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