E-Verify Self Check - Further Action Pursued

myE-Verify Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0117 can be found here:

Documents and Forms

Document Name Document Type
E-Verify Self Check - Further Action Pursued Form and Instruction
Self Check Content Document 1a. PRA_SelfCheck Content Document for PRA.docx Form and Instruction
Self Check Wireframes 1b. Self Check Wireframes_for PRA.PDF Form and Instruction
Self Check Content Document_ScreenShots 7-22-14.docx E-Verify Self-Check Screenshots (Comprehensive) IC Document

Information Collection (IC) Details

IC Title:	E-Verify Self Check - Further Action Pursued	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Self Check Content Document	1a. PRA_SelfCheck Content Document for PRA.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Self Check Wireframes	1b. Self Check Wireframes_for PRA.PDF		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: DHS/USCIS-013 E-Verify Self-Check	FR Citation: 76 FR 9034

Number of Respondents: 5,582	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,582	5,582
Annual IC Time Burden (Hours)	6,604	6,604
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
E-Verify Self-Check Screenshots (Comprehensive)	Self Check Content Document_ScreenShots 7-22-14.docx	07/24/2014

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