Document Verification Request and Document Verification Request Supplement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
dhsprivacy-pia-uscis-save-20110826.pdf	Supplementary Document	Uploaded 2011-12-08	Available
SORN SAVE Program 76 FR 58525 9-21-11.mht	Supplementary Document	Uploaded 2011-12-08	Source copy available
PTA USCIS-Form G-845 20110308 priv final.pdf	Supplementary Document	Uploaded 2011-07-14	Available
Supporting Statement (Rev) 12-8-11.doc	Supporting Statement A	Uploaded 2011-12-08	Available
TOC G-845 Supplement 5 19 2011.doc	Supplementary Document	Uploaded 2011-05-26	Available
TOC G-845 2 14 2011.doc	Supplementary Document	Uploaded 2011-05-26	Available
Reference Cites.doc	Supplementary Document	Uploaded 2011-05-26	Available
30-Day Notice Published 5-26-11.pdf	Supplementary Document	Uploaded 2011-05-26	Available
60-Day Notice Published 2-22-11 2011-3786.pdf	Supplementary Document	Uploaded 2011-05-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
21025	Document Verification Request and Document Verification Request Supplement	Instruction	Modified

ICR Details

OMB Control No: 1615-0101	ICR Reference No: 201105-1615-006
Status: Historical Active	Previous ICR Reference No: 200805-1615-019
Agency/Subagency: DHS/USCIS	Agency Tracking No:
Title: Document Verification Request and Document Verification Request Supplement
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: 01/08/2012
	Date Received in OIRA: 07/19/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	01/31/2012
Responses	12,099,345	0	10,238,232
Time Burden (Hours)	1,004,246	0	849,773
Cost Burden (Dollars)	6,416,358	0	1,802,574

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Abstract: In the verification process, a participating agency validates an applicant's immigration status by inputting identifying information into the Verification Information System (VIS), which executes immigration status queries against a range of data sources. If VIS returns an immigration status and the benefit-issuing agency does not find a material discrepancy with the response and the documents provided by the applicant, the verification process is complete. Then, the agency may use that immigration status information in determining whether or not to issue the benefit. In some cases, agencies that do not access the automated verification system may query USCIS by filing Form G-845. Although the Form G-845 does not require it, if needed certain agencies may also file the Form G-845 Supplement with the Form G-845, along with copies of immigration documents to receive additional information necessary to make their benefit determinations. These forms were developed to facilitate communication between all benefit-granting agencies and USCIS to ensure that basic information required to assess status verification requests is provided. USCIS is making minor revisions to the Form G-845 and is streamlining the Form G-845 Supplement with additional immigration statuses that are commonly requested by agencies in order to make their benefit determinations.

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Authorizing Statute(s): PL: Pub.L. 104 - 208 642 Name of Law: Illegal Immigration Reform and Immigrant Responsibility Act
   PL: Pub.L. 99 - 603 121 Name of Law: Immigration Reform and Control Act
  

Citations for New Statutory Requirements: None

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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:
	76 FR 9805	02/22/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 30738	05/25/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Document Verification Request and Document Verification Request Supplement	G-845 Supplement, G-845, Web Screen Shots	Document Verification Request Supplement ,   Verification Information System ,   Document Verification Request

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ICR Summary of Burden

table that charts list 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	12,099,345	10,238,232	0	0	1,861,113	0
Annual Time Burden (Hours)	1,004,246	849,773	0	0	154,473	0
Annual Cost Burden (Dollars)	6,416,358	1,802,574	0	4,613,784	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There has been an increase of 154,473 annual burden hours associated with this information collection. This increase can be attributed to increased registration of state and local agencies due to new state and local legislation, as well as more applicants applying for federal, state and local benefits during an economic downturn.

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Annual Cost to Federal Government: $225,940

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]? No

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: 07/19/2011

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