Waiver of Rights, Privileges, Exemptions and Immunities

ICR 200909-1615-001

OMB: 1615-0025

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2009-09-01
Supplementary Document
2009-09-01
Supporting Statement A
2009-09-01
Supplementary Document
2008-06-26
Supplementary Document
2008-06-26
IC Document Collections
ICR Details
1615-0025 200909-1615-001
Historical Active 200806-1615-013
DHS/USCIS
Waiver of Rights, Privileges, Exemptions and Immunities
Extension without change of a currently approved collection   No
Regular
Approved without change 11/17/2009
Retrieve Notice of Action (NOA) 09/14/2009
Approved for only two years due to partial GPEA compliance (fillable but not fileable option).
  Inventory as of this Action Requested Previously Approved
11/30/2011 36 Months From Approved 11/30/2009
2,000 0 2,000
166 0 166
0 0 0

This information will be used by the USCIS to determine eligibility of an alien applicant to retain the status of alien lawfully admitted to the United States for permanent residence.

US Code: 8 USC 1257 Name of Law: U.S. Code
  
None

Not associated with rulemaking

  74 FR 26411 06/02/2009
74 FR 45228 09/01/2009
No

  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 2,000 2,000 0 0 0 0
Annual Time Burden (Hours) 166 166 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$80,324
No
No
Uncollected
Uncollected
No
Uncollected
Stephen Tarragon 202-272-8358 [email protected]

  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.
09/14/2009


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