Arrival and Departure Record

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-94 Arrival and Departure Record I-94	Form and Instruction	Unchanged	Repair queued
Form I-94W I-94W Nonimmigrant Visa Waiver Arrival/Departure	Form and Instruction	Unchanged	Available
Statement most recent as of March 26 2014 with Chile.docx	Supporting Statement A	Uploaded 2014-03-31	Available
i94_website screenshot with PRA statement.gif	Supplementary Document	Uploaded 2013-03-04	Available
ESTA SORN.pdf	Supplementary Document	Uploaded 2011-01-05	Available
Travel Promotion Act.pdf	Supplementary Document	Uploaded 2010-07-13	Available
Non-Immigrant SORN.pdf	Supplementary Document	Uploaded 2010-04-15	Available
9-11 Act PL 110-53.doc	Supplementary Document	Uploaded 2010-03-18	Available
8 CFR 217 and 212 1(e).doc	Supplementary Document	Uploaded 2010-03-18	Available
privacy_pia_cbp_esta.pdf	Supplementary Document	Uploaded 2009-03-17	Repair queued
Supporting Laws.doc	Supplementary Document	Uploaded 2008-03-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
20892	Arrival and Departure Record I-94	Form and Instruction	Unchanged
206017	I-94 Website	Other-Website	Unchanged
184545	Electronic System for Travel Authorization (ESTA)	Other-null	Modified
184027	I-94W Nonimmigrant Visa Waiver Arrival/Departure	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1651-0111	ICR Reference No: 201403-1651-008
Status: Historical Active	Previous ICR Reference No: 201307-1651-003
Agency/Subagency: DHS/USCBP	Agency Tracking No:
Title: Arrival and Departure Record
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/29/2014
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/13/2014
	Date Received in OIRA: 03/31/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	6 Months From Approved	11/30/2014
Responses	28,855,231	0	28,675,231
Time Burden (Hours)	5,759,991	0	5,714,991
Cost Burden (Dollars)	256,147,300	0	254,005,300

---

Abstract: CBP requests to revise the ESTA information collection as a result of Chile be adding to the Visa Waiver Program. Form I-94 (Arrival/Departure Record) and Form I-94W (Nonimmigrant Visa Waiver Arrival/Departure) are used to document a traveler's admission into the United States. These forms include date of arrival, visa classification and the date the authorized stay expires. The forms are also used by business employers and other organizations to confirm legal status in the United States. The Electronic System for Travel Authorization (ESTA) applies to aliens traveling to the United States under the Visa Waiver Program (VWP) and requires that VWP travelers provide information electronically to CBP before embarking on travel to the United States. CBP revised the I-94 information collection to reflect a Final Rule that amends the DHS regulations by allowing certain nonimmigrant Mexican nationals presenting a Border Crossing Card, or other proper immigration documentation, to travel in New Mexico up to 55 miles from the border without filing a CBP Form I-94. The current regulations allow this only up to 25 miles from the border. As a result of this Final Rule, this ICR reflects a reduction of 12,450 I-94's submitted.

Emergency Justfication: This is associated with a Final Rule.

---

Authorizing Statute(s): PL: Pub.L. 110 - 53 711 Name of Law: 9/11 Act
   US Code: 8 USC 231 Name of Law: Immigration and Nationality Act
   PL: Pub.L. 111 - 145 9 Name of Law: Travel Promotion Act
   US Code: 8 USC 217 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1601-AA70	Final or interim final rulemaking	79 FR 17852	03/31/2014

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
I-94 Website
Electronic System for Travel Authorization (ESTA)
I-94W Nonimmigrant Visa Waiver Arrival/Departure	I-94W	Nonimmigrant Visa Waiver Arrival/Departure
Arrival and Departure Record I-94	I-94	Arrival/Departure Record

---

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	28,855,231	28,675,231	0	180,000	0	0
Annual Time Burden (Hours)	5,759,991	5,714,991	0	45,000	0	0
Annual Cost Burden (Dollars)	256,147,300	254,005,300	0	2,142,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The number of responses and burden hours were increased due to the addition of Chile to the Visa Waiver Program.

---

Annual Cost to Federal Government: $0

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

---

Common Form ICR:  No

---

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: 03/31/2014

---