Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified	Available
I102-INS-TOC-02262013.docx	Supplementary Document	Uploaded 2013-04-04	Available
Reference Citation.doc	Supplementary Document	Uploaded 2013-04-04	Available
I-94 IFR Published 3.27.13.pdf	Supplementary Document	Uploaded 2013-04-04	Available
1615-0079 052013.doc	Supporting Statement A	Uploaded 2013-05-10	Available
SORN - United States Citizenship and Immigration Services Benefits Information System.doc	Supplementary Document	Uploaded 2012-06-12	Available
PIA - USCIS Benefits Processing of Applicants other than.pdf	Supplementary Document	Uploaded 2012-06-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
20403	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified

ICR Details

OMB Control No: 1615-0079	ICR Reference No: 201304-1615-001
Status: Historical Active	Previous ICR Reference No: 201206-1615-003
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-102
Title: Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/10/2013
	Date Received in OIRA: 04/09/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2014	36 Months From Approved	02/28/2015
Responses	6,782	0	17,700
Time Burden (Hours)	2,821	0	7,363
Cost Burden (Dollars)	0	0	0

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Abstract: An alien temporarily residing in the United States can use this form to request a replacement of his or her lost, stolen, mutilated arrival-departure document, or he or she may also request a new arrival-departure record, if one was not issued when he or she was last admitted as a nonimmigrant, and has not since been issued such record but is in need of one USCIS uses the information provided by the requester to verify eligibility, as well as his or her status, process the request and issue a new or replacement arrival-departure record.

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Authorizing Statute(s): US Code: 8 USC 1304 Name of Law: U.S. Code
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1651-AA96	Final or interim final rulemaking	78 FR 18457	03/27/2013

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

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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	6,782	17,700	0	-10,918	0	0
Annual Time Burden (Hours)	2,821	7,363	0	-4,542	0	0
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Changing Regulations

Short Statement: There has been a decrease in the estimated annual burden hours by 4,541.89 burden hours. There is a change in the estimated number of respondents from 17,700 to 6,782. This change in the estimate is due to the implementation of the changes introduced by CBP's automation of Form I-94 and issuance of electronic Forms I-94 in lieu of paper Forms I-94, as authorized by the interim rule referenced above in the response to question 2. USCIS has revised the instructions to the form to reflect changes in the process prompted by the interim final rule.

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Annual Cost to Federal Government: $2,238,959

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: 04/09/2013

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