Supporting Statement A 161500097 G-646 2014-11-1

SUPPORTING STATEMENT FOR

SWORN STATEMENT OF REFUGEE APPLYING FOR ADMISSION INTO THE UNITED STATES OMB Control No.: 1615-0097

COLLECTION INSTRUMENT(S): G-646

A. Justification

1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

Section 207 of the Immigration and Nationality Act (INA) authorizes the Secretary of the Department of Homeland Security to admit refugees that are admissible. The information collection required on Form G-646, Sworn Statement of Refugee Applying for Admission into the United States, is necessary for U.S. Citizenship and Immigration Services (USCIS) to determine that the applicant meets all admissibility grounds and conditions. Upon approval of the application for refugee status the applicant is eligible for admission to the United States as a refugee.

Authority: Section 207 of the INA

2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

USCIS uses the data collected on this form to determine applicants’ eligibility for admission to the United States as refugees. The form serves the purpose of ensuring that applicants provide basic information required to assess eligibility, and standardizes requests for the benefit. Persons applying for admission to the U.S. must show that they are admissible to the U.S. and not barred from refugee status. This form collects information related to admissibility and mandatory bars.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

The use of this form provides the most efficient means for collecting and processing the required data. In this case, DHS does not employ the use of information technology in collecting and processing information as the G-646 serves as a sworn statement, and the questions must be answered in the presence of a USCIS officer. DHS does not have the automated capability in place to accept the electronic submission of this type of application. In addition, the processing of most applications for refugee status occurs in remote areas of the world without access to such information technology. This form cannot be submitted electronically.

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

There is no other form that collects the same information for the required purpose, there is no duplication of information.

5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.

This collection of information does not have an impact on small business or other small entities.

6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

Without this information collection, USCIS will not be able to determine the admissibility of refugees.

7. Explain any special circumstances that would cause an information collection to be conducted in a manner:

• Requiring respondents to report information to the agency more often than quarterly;

• Requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

• Requiring respondents to submit more than an original and two copies of any document;

• Requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

• In connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;

• Requiring the use of a statistical data classification that has not been reviewed and approved by OMB;

• That includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

• Requiring respondents to submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

This information collection is conducted in a manner consistent with the guidelines in 5 CFR 1320.5(d)(2).

8. If applicable, provide a copy and identify the data and page number of publication in the Federal Register of the agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.

Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping, disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or reported.

Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years - even if the collection of information activity is the same as in prior periods. There may be circumstances that may preclude consultation in a specific situation. These circumstances should be explained.

On March 27, 2014 USCIS published a 60-day notice in the Federal Register at 79 FR 17171. USCIS did receive 2 comments after publishing that notice. One comment agreed with the stated purpose of the form and the other comment was directed at the general program requirements which are required by law to be performed. USCIS thanks the commenters for taking the time to provide feedback to the agency.

On October 07, 2014, USCIS published a 30-day notice in the Federal Register at 79 FR 60489. USCIS did not receive comments.

9. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.

USCIS does not provide any payment for benefit sought.

10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation or agency policy.

There is no assurance of confidentially provided to the respondents. The information collected is covered under the System of Records Notice Alien File, Index, and National File Tracking System of Records published November 23, 2013 at 78 FR 69864 and under the Privacy Impact Assessment titled “Integrated Digitization Document Management Program” dated January 5, 2007.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

Questions of a sensitive nature regarding particular behavior, health conditions and particular beliefs are required to determine admissibility to the United States. This information is used to determine an applicant's admissibility.

12. Provide estimates of the hour burden of the collection of information. The statement should:

• Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices.

• If this request for approval covers more than one form, provide separate hour burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-I.

• Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 14.

Type of Respondent	Form Name / Form Number	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response (in hours)	Total Annual Burden (in hours)	Avg. Hourly Wage Rate*	Total Annual Respondent Cost
Individuals or households	G-646	75,000	1	.333	24,975	$31.26	$780,719
Total		75,000			24,975		$780,719

* The above Average Hourly Wage Rate is the May 2013 Bureau of Labor Statistics average wage for All Occupations of $22.33 times the wage rate benefit multiplier of 1.4 (to account for benefits provided) equaling $31.26.  When “All Occupations” is selected, include the following language: “The selection of “All Occupations” was chosen as the expected respondents for this collection could be expected to be from any occupation.”

13. Provide an estimate of the total annual cost burden to respondents or record keepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14).

• The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance and purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities.

• If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.

• Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995; (2) to achieve regulatory compliance with requirements not associated with the information collection; (3) for reasons other than to provide information or keep records for the government; or, (4) as part of customary and usual business or private practices.

There are no costs to the respondents, these questions are asked in the presence of a government employee and there is no document gathering, attorney fee, or anything else required that would incur and expense.

14. Provide estimates of annualized cost to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a single table.

Annualized Cost Analysis:

1. Printing Cost $ 13,500

2. Collection and Processing Cost $ 1,582,500

3. Total Cost to Program $ 1,596,000

Government Cost

The estimated cost to the Government is $1,596,000. This figure is calculated by multiplying the estimated number of respondents 75,000 x .50 (30 minutes) (time required to collect and process information) x $42.32 (suggested average hourly rate for GS-11 clerical, officer and supervisory time with benefits). In addition, this figure includes the estimated overhead cost for printing, stocking, and distributing the form that is $13,500.

15. Explain the reasons for any program changes or adjustments reporting in Items 13 or 14 of the OMB Form 83-I.

There are no changes to the burden or information being collected.

16. For collections of information whose results will be published, outline plans for tabulation, and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

This information collection will not be published for statistical purposes.

17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

USCIS will display the expiration date for OMB approval of this information collection.

18. Explain each exception to the certification statement identified in Item 19, “Certification for Paperwork Reduction Act Submission,” of OMB 83-I.

USCIS does not request an exception to the certification of this information collection.

B. Collections of Information Employing Statistical Methods.

There is no statistical methodology involved with this collection.

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