Information Collection

E-Verify Self Check - Further Action Pursued

IC 210425 under ICR 201402-1615-002 · OMB 1615-0117.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.