Arrival and Departure Record

Forms and Documents

Document Name	Status
Form I-94 Arrival and Departure Record I-94 Form and Instruction	Modified
Form I-94W I-94W Nonimmigrant Visa Waiver Arrival/Departure Form and Instruction	Modified
Travel Promotion Act.pdf Supplementary Document	2010-07-13
1651-0111 Statement 7-28-2010 without fee.docx Supporting Statement A	2010-07-28
Statement 4-8-2010 without feeSHOWING REVISIONS.doc Supplementary Document	2010-04-15
Non-Immigrant SORN.pdf Supplementary Document	2010-04-15
FR 30 2010.pdf Supplementary Document	2010-03-19
9-11 Act PL 110-53.doc Supplementary Document	2010-03-18
8 CFR 217 and 212 1(e).doc Supplementary Document	2010-03-18
FR 60 2009.pdf Supplementary Document	2010-03-18
privacy_pia_cbp_esta.pdf Supplementary Document	2009-03-17
Supporting Laws.doc Supplementary Document	2008-03-04

IC Document Collections

IC ID	Document Title	Status
20892	Arrival and Departure Record I-94 Form and Instruction	Modified
184545	Electronic System for Travel Authorization (ESTA) Other-website	Modified
184027	I-94W Nonimmigrant Visa Waiver Arrival/Departure Form and Instruction	Modified

ICR Details

OMB Control No: 1651-0111	ICR Reference No: 201003-1651-002
Status: Historical Active	Previous ICR Reference No: 200903-1651-001
Agency/Subagency: DHS/USCBP	Agency Tracking No:
Title: Arrival and Departure Record
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/28/2010
	Date Received in OIRA: 04/19/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2011	36 Months From Approved	07/31/2010
Responses	33,000,000	0	49,924,380
Time Burden (Hours)	6,600,300	0	8,745,943
Cost Burden (Dollars)	84,600,000	0	191,546,280

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Abstract: Form I-94 (Arrival/Departure Record) and Form I-94W (Nonimmigrant Visa Waiver Arrival/Departure Record) are used to document a traveler's admission into the United States. These forms include date of arrival, visa classification and the date the authorized stay expires. The forms are also used by business employers and other organizations to confirm legal status in the United States. The Electronic System for Travel Authorization (ESTA) applies to aliens traveling to the United States under the Visa Waiver Program (VWP) and requires that VWP travelers provide information electronically to CBP before embarking on travel to the United States.

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Authorizing Statute(s): US Code: 8 USC 217 Name of Law: Immigration and Nationality Act
   US Code: 8 USC 231 Name of Law: Immigration and Nationality Act
   PL: Pub.L. 110 - 53 711 Name of Law: 9/11 Act
   PL: Pub.L. 111 - 145 9 Name of Law: Travel Promotion Act
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 53 711 Name of Law: 9/11 Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 64092	12/07/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 13293	03/19/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Electronic System for Travel Authorization (ESTA)
I-94W Nonimmigrant Visa Waiver Arrival/Departure	I-94W	Nonimmigrant Visa Waiver Approval/Departure
Arrival and Departure Record I-94	I-94	Arrival/Departure Record

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ICR Summary of Burden

	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	33,000,000	49,924,380	0	-15,000,000	-1,924,380	0
Annual Time Burden (Hours)	6,600,300	8,745,943	0	-1,772,700	-372,943	0
Annual Cost Burden (Dollars)	84,600,000	191,546,280	0	-101,400,000	-5,546,280	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Public Law 110-53. Section 711 of the 9/11 Act authorizes the Secretary of Homeland Security to collect a fee to “ensure the recovery of the full costs of providing and administering the system.”

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 04/19/2010

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