Information Collection

E-Verify Self Check Program

IC 195662 under ICR 201012-1615-003 · OMB 1615-0117.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0117 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screen Shots Self Check 12-8-10.pdf	Other-Screen Shots
E-Verify Self Check Website Content - 12-21-10.doc	Other-Screen Shot in Word Document 1

IC Title:

E-Verify Self Check Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Other-Screen Shots			Screen Shots Self Check 12-8-10.pdf		Yes	Yes	Fillable Fileable
Other-Screen Shot in Word Document 12-21-10			E-Verify Self Check Website Content - 12-21-10.doc		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,080,582

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,080,582	5,080,582
Annual IC Time Burden (Hours)	429,352	429,352
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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