Application for Waiver of Passport and/or Visa

Forms and Documents

Document Name	Status
Form I-193 Application for Waiver of Passport and/or Visa Form	Modified
Statement 2011.DOC Supporting Statement A	2011-07-05
privacy_pia_cis_claims3.pdf Supplementary Document	2011-06-14
SORN.mht Supplementary Document	2011-06-14
FR 30 2011.pdf Supplementary Document	2011-06-14
FR 60 2011.pdf Supplementary Document	2011-06-14
Supporting Law.DOC Supplementary Document	2008-06-24

IC Document Collections

IC ID	Document Title	Status
20885	Application for Waiver of Passport and/or Visa Form	Modified

ICR Details

OMB Control No: 1651-0107	ICR Reference No: 201106-1651-001
Status: Historical Active	Previous ICR Reference No: 201012-1651-001
Agency/Subagency: DHS/USCBP	Agency Tracking No:
Title: Application for Waiver of Passport and/or Visa
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/05/2011
	Date Received in OIRA: 07/05/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved	10/31/2011
Responses	25,000	0	25,000
Time Burden (Hours)	4,150	0	4,150
Cost Burden (Dollars)	14,625,000	0	14,625,000

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Abstract: DHS Form I-193 is used by an aliens who wishe to waive the documentary requirements for passports and/or visas due to an unforeseen emergency. CBP uses this information to determine whether the applicant is eligible for entry into the United States.

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Authorizing Statute(s): US Code: 8 USC 211 and 212 Name of Law: Immigration and Nationality 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 17426	03/29/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 34740	06/14/2011
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Application for Waiver of Passport and/or Visa	I-193	Application for Waiver of Passport and/or Visa

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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	25,000	25,000	0	0	0	0
Annual Time Burden (Hours)	4,150	4,150	0	0	0	0
Annual Cost Burden (Dollars)	14,625,000	14,625,000	0	0	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:

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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]? 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: 07/05/2011

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