Application for Employment Authorization

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-765 Application for Employment Authorization	Form	Modified	Available
I765-TOC-INS-OMBPassBack03092012.doc	Supplementary Document	Uploaded 2012-03-19	Available
I765-TOC-FRM-OMBPassBack03092012.doc	Supplementary Document	Uploaded 2012-03-19	Available
I-765 Supporting Statement 4-17-12.doc	Supporting Statement A	Uploaded 2012-04-17	Available
Reference citation.doc	Supplementary Document	Uploaded 2011-09-01	Available
SORN - United States Citizenship and Immigration Services Benefits Information System.doc	Supplementary Document	Uploaded 2011-09-01	Available
PIA - USCIS Benefits Processing of Applicants other than.pdf	Supplementary Document	Uploaded 2011-09-01	Available
Published 30-day notice 07_20_11.doc	Supplementary Document	Uploaded 2011-09-01	Available
Published I-765 60-day notice 4-19-11.pdf	Supplementary Document	Uploaded 2011-09-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
20321	Application for Employment Authorization	Form	Modified

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201109-1615-001
Status: Historical Active	Previous ICR Reference No: 201101-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No:
Title: Application for Employment Authorization
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 with change	Conclusion Date: 04/25/2012
	Date Received in OIRA: 09/20/2011
Terms of Clearance: Any future submission of this package shall be consistent with the table of changes (written in response to public comments) uploaded to the supplementary documents section. USCIS will pursue a system release of I-765 in order to recognize the changed form through their lockbox operation. Currently the USCIS Lockbox facilities will only intake a mirror image of the existing form, or an accepted prior version of the form. USCIS shall continue to take actions to completely reformat and revise Form I-765. The revised version shall address all inconsistencies within the form instructions and form; these updates shall greatly improve customer service and decrease the reject rate due to improper completion of the form. A system release to intake the revised form shall be scheduled for November 30, 2012. As shown by the corrections to this collection, USCIS shall continue to distinguish between fee costs and paperwork costs in calculating the annual cost burden to the public.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved	04/30/2012
Responses	720,000	0	720,000
Time Burden (Hours)	2,459,520	0	2,458,800
Cost Burden (Dollars)	0	0	273,600,000

---

Abstract: The information will be used by the USCIS to determine eligibility for work authorization and for the issuance of the employment document.

---

Authorizing Statute(s): US Code: 8 USC 1153 Name of Law: Immigration Nationality Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 21912	04/19/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 43335	07/20/2011
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Employment Authorization	I-765	Application for Employment Authorization

---

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	720,000	720,000	0	0	0	0
Annual Time Burden (Hours)	2,459,520	2,458,800	0	0	720	0
Annual Cost Burden (Dollars)	0	273,600,000	0	0	-273,600,000	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 a small increase of 720 annual burden hours previously reported for this information collection. This can be attributed to a mathematical error in USCIS's last submission associated with the time it takes an applicant to complete the form. USCIS has made some changes to the form based on the comments it received as a result of the 60-day information collection notice.

---

Annual Cost to Federal Government: $273,600,000

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

---

Common Form ICR:  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:

(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: 09/20/2011

---