I-865 Supp Statement 2012-7-6

Supporting Statement

Sponsor’s Notice of Change of Address, Form I-865

OMB No. 1615-0076

A. JUSTIFICATION:

1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

The Illegal Immigration Reform and Immigrant Responsibility Act of 1996 created section

213A of the Immigration and Nationality Act (Act). Section 213A(d)(1) of the Act requires

every sponsor to notify the U.S. Citizenship and Immigration Services (USCIS) of his or her

new address within 30 days of any change of address. The sponsor will meet this obligation

by filing this form with the USCIS.

2. Indicate how, by whom, and for what purpose the information is to be used. Except

for a new collection, indicate the actual use the agency has made of the information

received from the current collection.

The data collected on Form I-865 will be used by an entity that has provided any means-tested public benefit to a sponsored alien to locate and require reimbursement from the sponsor for an amount equal to the unreimbursed costs of the provided benefits.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

The use of Form I-865 provides the most efficient means for collecting and processing the required data. This form can be completed electronically on the USCIS Web site but cannot be e-filed. However, this form has been designated for e-filing under the Business Transformation Project.

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

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

5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.

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

6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

If the information is not collected, providers would not have information on sponsors of

aliens that may receive means-tested public benefits, and it may prove difficult to pursue the reimbursement of unreimbursed costs from sponsors.

7. Explain any special circumstances that would cause an information collection to be conducted in a manner:

• Requiring respondents to report information to the agency more often than quarterly;

• requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

• requiring respondents to submit more than an original and two copies of any document;

• requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

• In connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;

• requiring the use of a statistical data classification that has not been reviewed and approved by OMB;

• that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

• requiring respondents to submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

This information collection is conducted in a manner consistent with the guidelines in 5 CFR 1320.5(d)(2).

8. If applicable, provide a copy and identify the data and page number of publication in the Federal Register of the agency's notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.

On July 24,2012, USCIS published a 60-day notice in the Federal Register at 77 FR 43345. USCIS did not receive any comments on the 60-day notice. On October 3, 2012, USCIS published a 30-day notice in the Federal Register at 77 FR 60453. USCIS has received one comment on the 30-day notice to date.

The commenter asks that USCIS end legal immigration or require sponsors to have at least one million dollars in assets.  Filing an Affidavit of Support is a statutory requirement under Section 213A of the Immigration and Nationality Act.  The comments do not justify a change to any aspect of Form I-865, Sponsor’s Notice of Change of Address at this time.

9. Explain any decision to provide any payment or gift to respondents, other than

remuneration of contractors or grantees.

The USCIS does not provide payments or gifts to respondents in exchange for a benefit

sought.

10. Describe any assurance of confidentiality provided to respondents and the basis for the

assurance in statute, regulation or agency policy.

There is no assurance of confidentiality. The system of record notice associated with this

information collection is United States Citizenship and Immigration Services Benefits

Information System, which was published in the Federal Register on September 29, 2008 at

73 FR 56596. The privacy impact assessment associated with this information collection is

USCIS Benefits Processing of Applicants other than Petitions for Naturalization, Refugee

Status, and Asylum.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to person’s form whom the information is requested, and any steps to be taken to obtain their consent.

There are no questions of a sensitive nature.

12. Provide estimates of the hour burden of the collection of information. The statement should:

• Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices.

• If this request for approval covers more than one form, provide separate hour burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-I.

• Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 14.

Type of Respondent	Form Name / Form Number	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response (in hours)	Total Annual Burden (in hours)	Avg. Hourly Wage Rate	Total Annual Respondent Cost
Individuals or households	I-865/Sponsor’s Notice of Change of Address	100,000	1	.25	25,000	$30.74	$768,500
Total		100,000			25,000		$768,500

13. Provide an estimate of the total annual cost burden to respondents or record keepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14).

• The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance and purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities.

• If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.

• Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the government or (4) as part of customary and usual business or private practices.

There are no start-up, capital, operational or maintenance costs associated with this collection

of information. For information purpose, there are no fee charges associated with the

collection of this information.

14. Provide estimates of annualized cost to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a single table.

Annualized Cost Analysis:

1. Printing Cost $ 18,000

2. Collection and Processing Cost $ 1,000,000

3. Total Cost to Government $ 1,018,000

Government Cost

The estimated cost of the program to the Government is $1,018,000. This figure is calculated by multiplying the estimated number of respondents (50) x (1) number of response x (1) hour (USCIS 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, distributing and processing of this form which is $10.

15. Explain the reasons for any program changes or adjustments reporting in Items 13 or 14 of the OMB Form 83-I.

There are no changes to the estimated annual hours burden or estimated annual costs from Questions 13 and 14 of the OMB Form 83-I.

16. For collections of information whose results will be published, outline plans for tabulation, and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

This information collection will not be published for statistical purposes.

17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

USCIS will display the expiration date for OMB approval of this information collection.

18. Explain each exception to the certification statement identified in Item 19, "Certification for Paperwork Reduction Act Submission," of OMB 83-I.

USCIS does not request an exception to the certification of this information collection.

B. Collection of Information Employing Statistical Methods.

There is no statistical methodology involved with this collection.

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