Information Collection

Application for Cancellation of Removal: 42A) for Certain Permanent Residents, and 42B) Adjustment of Status for Certain Nonpermanent Residents

IC 12666 under ICR 200206-1125-005 · OMB 1125-0001.

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Documents and Forms

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Document Name	Document Type

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IC Title:

Application for Cancellation of Removal: 42A) for Certain Permanent Residents, and 42B) Adjustment of Status for Certain Nonpermanent Residents

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	EOIR-42A				No	No
Form	42B				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,000	6,875	4,125
Annual IC Time Burden (Hours)	63,250	39,532	23,718
Annual IC Cost Burden (Dollars)	1,100,000	687,000	413,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.