Application for Authorization to Issue Certification for Health Care Workers and Related Requirements

ICR 200511-1615-001

OMB: 1615-0086

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1615-0086 200511-1615-001
Historical Active 200309-1615-001
DHS/USCIS
Application for Authorization to Issue Certification for Health Care Workers and Related Requirements
Revision of a currently approved collection   No
Regular
Approved with change 06/27/2006
Retrieve Notice of Action (NOA) 11/30/2005
  Inventory as of this Action Requested Previously Approved
06/30/2009 06/30/2009 06/30/2006
28,010 0 10
51,280 0 40
4,552,000 0 2,000

This form is necessary for an organization to request authorization from the USCIS to issue certificates to foreign health care workers. The data collected on this form is used by the USCIS to determine eligibility to issue certificates.

None
None


No

1
IC Title Form No. Form Name
Application for Authorization to Issue Certification for Health Care Workers and Related Requirements I-905

  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 28,010 10 0 28,000 0 0
Annual Time Burden (Hours) 51,280 40 0 51,240 0 0
Annual Cost Burden (Dollars) 4,552,000 2,000 0 4,550,000 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.
11/30/2005


© 2024 OMB.report | Privacy Policy