Application for Temporary Protected Status

ICR 200012-1115-004

OMB: 1115-0170

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
12089 Migrated
ICR Details
1115-0170 200012-1115-004
Historical Active 199904-1115-007
DOJ/INS
Application for Temporary Protected Status
Extension without change of a currently approved collection   No
Regular
Approved without change 03/14/2001
Retrieve Notice of Action (NOA) 12/27/2000
Approved consistent with changes detailed in INS memo dated 3/6/01, including: -- Fixing printing error (lost line) on "Instructions, #1" -- Changing the comma after "receipts" (Instructions, #5f) to a semi-colon. -- Changing Eligibility Standards: 1. to read "I am a national of, or an alien... foreign state of, ----"
  Inventory as of this Action Requested Previously Approved
03/31/2004 03/31/2004 03/31/2001
181,000 0 181,000
90,500 0 90,500
8,800,000 0 86,000

This information provided will be used by the Service to determine whether an applicant for Temporary Protected Status meets the eligibility requirements.

None
None


No

1
IC Title Form No. Form Name
Application for Temporary Protected Status I-821, I-821A

  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 181,000 181,000 0 0 0 0
Annual Time Burden (Hours) 90,500 90,500 0 0 0 0
Annual Cost Burden (Dollars) 8,800,000 86,000 0 0 8,714,000 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.
12/27/2000


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