Application to Determine Returning Resident Status

Forms and Documents

Document Name	Status
Form DS-117 Application to Determine Returning Resident Status Form and Instruction	Modified
DS-0117 Legal Authorities (10-2013).docx Supplementary Document	2013-10-21
DS-0117 Supporting Statement (10-2013).docx Supporting Statement A	2013-10-21

IC Document Collections

IC ID	Document Title	Status
14917	Application to Determine Returning Resident Status Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0091	ICR Reference No: 201310-1405-001
Status: Historical Active	Previous ICR Reference No: 201009-1405-006
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Application to Determine Returning Resident Status
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 without change	Conclusion Date: 11/25/2013
	Date Received in OIRA: 10/21/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2016	36 Months From Approved	11/30/2013
Responses	1,005	0	875
Time Burden (Hours)	503	0	438
Cost Burden (Dollars)	0	0	315,000

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Abstract: Department of State consular officers use Form DS-117 to elicit information to determine the eligibility of an alien applicant for special immigrant classification as a returning resident.

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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 36011	06/14/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 60993	10/02/2013
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
Application to Determine Returning Resident Status	DS-117	Application to Determine Returning Resident Status

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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	1,005	875	0	0	130	0
Annual Time Burden (Hours)	503	438	0	0	65	0
Annual Cost Burden (Dollars)	0	315,000	0	0	-315,000	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: Burden change due to increased number of respondents and to change in fees mistakenly attributed to respondents on last submission.

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Annual Cost to Federal Government: $276,375

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: 10/21/2013

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