Supporting_Statement_A_1601_0004 12082011

SUPPORTING STATEMENT

Case Assistance Worksheet

(Form DHS-7001)

OMB No. 1601-0004

A. Justification:

1. The Citizenship and Immigration Services (CIS) Ombudsman was created under section 452 of the Homeland Security Act of 2002 (Public Law 107-296) to: (1) assist individuals and employers in resolving problems with the U.S. Citizenship and Immigration Services (USCIS); (2) to identify areas in which individuals and employers have problems in dealing with USCIS; and (3) to the extent possible, propose changes in the administrative practices of USCIS to mitigate problems. This form is used by an applicant who is experiencing problems with USCIS during the processing of an immigration benefit.

2. The information collected on this form will allow the CIS Ombudsman to identify the problem such as: (1) a case problem which is a request for information about a case that was filed with USCIS (“case problem”); or (2) the identification of a systemic issue that may or may not pertain to an individual case which the individual, attorney or employer is seeking to bring to the attention of the CIS Ombudsman (“trend”).

For case problems, the CIS Ombudsman will refer case specific issues to the Customer Assistance Office for USCIS for further research, and review.

For trends received, the CIS Ombudsman notes the systemic issue identified in the correspondence which may or may not be incorporated into future recommendations submitted to the Director of USCIS pursuant to section 452(d)(4) of Public Law 107-296.

3. The use of this form provides the most efficient means for collecting and processing the required data. The CIS Ombudsman anticipates employing the use of information technology in collecting and processing information by offering the option for electronic submission of the DHS Form 7001 in FY2012.

4. A review of the DHS Forms Inventory Report revealed no duplication of effort, and there is no other similar information currently available which can be used for this purpose.

5. This information collection does not have an impact on small businesses or other small entities.

6. If this information is not collected the CIS Ombudsman will not be able to identify problem areas, propose changes, and assist individuals experiencing problems during the processing of an immigration benefit with USCIS.

7. The special circumstances contained in item 7 of the supporting statement are not applicable to this information collection.

8. The CIS Ombudsman’s published a 60-day notice in the

Federal Register on August 18, 2011 at 79 FR 42129 and a 30-day notice on October 5, 2011, at 76 FR 61725 requesting comments from the public. No comments were received from either of the notices requesting comments.

9. CIS Ombudsman does not provide payments or gifts to

respondents in exchange for a benefit sought.

10. The assurance of confidentiality provided to the respondents for this information collection is provided by: (a) the Privacy Impact Assessment for the Office of the Citizenship & Immigration Services Ombudsman (CISOMB) Virtual Ombudsman System (March 19, 2010) and the (b) Systems of Records Notice: 9110-9B DEPARTMENT OF HOMELAND SECURITY, Office of the Secretary [Docket No. DHS-2009-0146] Privacy Act of 1974; Department of Homeland Security Citizenship and Immigration Services Ombudsman – 001 Online Ombudsman Form DHS -7001 System of Records.

The CISOMB Form DHS-7001 and the Online Ombudsman Form DHS -7001 system will be constructed in compliance with all applicable DHS Privacy Office, DHS CIO, DHS Records Management, and OMB regulations regarding data collection, use, storage, and retrieval. The proposed public use data collection system is therefore intended to be distributed for public use primarily by electronic means with limited paper distribution and processing of paper forms.

The CISOMB Form DHS-7001 and the Online Ombudsman Form DHS -7001 system has been constructed on the advice of the DHS Privacy Office, DHS CIO, DHS Records Management, and OMB regulations regarding data collection, use, sharing, storage, and retrieval of information.

In accordance with the Privacy Act of 1974, the Department of Homeland Security is giving notice that it proposes to establish a new Department of Homeland Security system of records notice titled, “Department of Homeland Security Citizenship and Immigration Services Ombudsman – 001 Online Ombudsman Form DHS -7001 System of Records.” This system of records will ensure the efficient and secure processing of information to aid the Citizenship and Immigration Services Ombudsman in providing assistance to individuals, employers, and their representatives in resolving problems with U.S. Citizenship and Immigration Services; identify areas in which individuals, employers, and their representatives have problems working with U.S. Citizenship and Immigration Services; and to the extent possible, propose changes to mitigate problems pursuant to 6 U.S.C. § 272. This newly established system will be included in the Department of Homeland Security’s inventory of record systems.

11. There are no questions of a sensitive nature.

12. Annual Reporting Burden:

a. Number of Respondents 2,600 b. Number of Responses 1

c. Total Annual Responses 2,600

d. Hours per Response 1

e. Total Annual Reporting Burden 2,600

The projected hours per response for this collection of information were derived by first breaking the process into three basic components:

Learning about the Law and the Form: 20 Minutes

Completion of the Form: 30 Minutes

Assembling and Filing the Form: 10 Minutes

Total Hours per Response 1 Hour

Total annual reporting burden hours is 2,600. This figure was derived by multiplying the number of respondents (2,600) x frequency of response (1) x hours per response (1 hour).

13. There are no capital or start-up costs associated with this information collection. Any cost burdens to respondents as a result of this collection are identified in question 14.

14. Annualized Cost Analysis:

a. Printing Cost $ 2,500

b. Collecting and Processing $ 104,000

c. Total Cost to Program $ 106,500

d. Fee Charge $ 0

e. Total Annual Cost to Government $ 106,500

Government Cost

The estimated cost to the Government is $106,500. This figure is calculated by multiplying the estimated number of respondents 2,600 x 1 hour (1.0) (time required to collect and process information) x $40 (Suggested average hourly rate for clerical, officer, and supervisory time with benefits). In addition, this figure includes the estimated overhead cost for printing, stocking, and distributing the form which is $2,500.

Public Cost

The estimated annual public cost is $26,000. This figure is calculated by multiplying the number of respondents 2,600 x 1 hour (1.0) per response x $10 (average hourly rate).

15. There has been no increase or decrease in the estimated annual burden hours previously reported for this information collection.

There is no change in the information being collected, however there have been cosmetic changes to the form including punctuation and formatting.

The title of the form has changed from “Case Problem Submission Worksheet (CIS Ombudsman Form DHS-7001)” to “Case Assistance Form (Form DHS-7001)”

The name of the system has changed from “Virtual Ombudsman System” to “Online Ombudsman Form DHS-7001”.

There is no change in the burden associated with this collection.

The instructions have been updated to reflect the electronic submission options.

Instructions for electronic submission will be posted on the CIS Ombudsman website at www.dhs.gov/cisombudsman.

The terms of clearance from the previously approved collection have been addressed by updates to the:(a) Privacy Impact Assessment for the Office of the Citizenship & Immigration Services Ombudsman (CISOMB) Virtual Ombudsman System (March 19, 2010); and the (b) Systems of Records Notice: 9110-9B DEPARTMENT OF HOMELAND SECURITY, Office of the Secretary [Docket No. DHS-2009-0146] Privacy Act of 1974; Department of Homeland Security Citizenship and Immigration Services Ombudsman – 001 Virtual Ombudsman System (March 2010) to reflect the name change to Online Ombudsman Form DHS -7001 System of Records.

16. CIS Ombudsman does not intend to employ the use of statistics or the publication thereof for this collection of information.

17. CIS Ombudsman will display the expiration date for OMB approval of this information collection.

18. CIS Ombudsman does not request an exception to the certification of this information collection.

2. Collection of Information Employing Statistical Methods.

This ICR does not contain surveys, censuses, or employ statistical methods.

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