Information Collection

Application for Employment Authorization

IC 20321 under ICR 201212-1615-001 · OMB 1615-0040.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0040 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
I765-INS-30Day-02152013.pdf	Instruction
I-765 Application for Employment Authorization I765-FRM-30Day-02152013.pdf	Form

IC Title:

Application for Employment Authorization

Agency IC Tracking Number:

I-765

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 274a.13 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			I765-INS-30Day-02152013.pdf		Yes	No	Printable Only
Form	I-765	Application for Employment Authorization	I765-FRM-30Day-02152013.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Electronic Immigration System-3 Automated Background Functions, DHS/USCIS-016

FR Citation: 76 FR 70735

Number of Respondents: 1,420,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,420,000	-341,300	1,761,300
Annual IC Time Burden (Hours)	4,856,400	-1,167,246	6,023,646
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.