Interagency Alien Witness and Informant Record

Forms and Documents

Document Name	Status
Form I-854 Interagency Alien Witness and Informant Record Form	Modified
I854-INS-TOC-30Day-051762013.docx Supplementary Document	2013-05-17
Supporting Statement 1615-0046 I-854 2013-5-6.doc Supporting Statement A	2013-05-17
SORN.htm Supplementary Document	2013-05-16
PIA.pdf Supplementary Document	2013-05-16
I-854 Reference Citations.doc Supplementary Document	2013-05-13
Published 60-Day Notice 1-25-2013.docx Supplementary Document	2013-05-13
Published 60-Day Notice 1-25-2013.docx Supplementary Document	2013-05-13

IC Document Collections

IC ID	Document Title	Status
20332	Interagency Alien Witness and Informant Record Form	Modified

ICR Details

OMB Control No: 1615-0046	ICR Reference No: 201304-1615-003
Status: Historical Active	Previous ICR Reference No: 201001-1615-003
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-854
Title: Interagency Alien Witness and Informant Record
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: 07/24/2013
	Date Received in OIRA: 05/30/2013
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	36 Months From Approved	07/31/2013
Responses	136	0	125
Time Burden (Hours)	578	0	531
Cost Burden (Dollars)	0	0	0

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Abstract: This form is used by law enforcement agencies (LEA's) to bring alien witnesses and informants to the United States in "S" nonimmigrant classification. This form also provides Department of State and USCIS with information necessary to identify the requesting LEA, and the the alien witness. This form will provide a critical record of the waivers, terms and conditions, and certifications that are prerequisite to the S nonimmigrant status and a subsequent request to allow an S nonimmigrant to adjust to lawful permanent resident status.

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Authorizing Statute(s): US Code: 8 USC 1101 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 5477	01/25/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 24429	04/25/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Interagency Alien Witness and Informant Record	I-854	Interagency Alien Witness and Informant Record

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ICR Summary 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	136	125	0	0	11	0
Annual Time Burden (Hours)	578	531	0	0	47	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: No

Burden Reduction Due to:

Short Statement: There has been an increase of 47 annual burden hours previously reported for this information collection. This change can be attributed to an adjustment in the agency estimate for the number of respondents from 125 respondents to 136.

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Annual Cost to Federal Government: $5,440

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: 05/30/2013

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