Application for Status as a Temporary Resident Under Section 245A of the Immigration and Nationality Act

ICR 201501-1615-005

OMB: 1615-0090

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2015-01-27
Supplementary Document
2015-01-27
Supporting Statement A
2015-01-27
Supplementary Document
2015-01-26
Supplementary Document
2015-01-26
Supplementary Document
2012-08-22
Supplementary Document
2010-07-29
Supplementary Document
2010-07-29
ICR Details
1615-0090 201501-1615-005
Historical Active 201208-1615-006
DHS/USCIS I-687
Application for Status as a Temporary Resident Under Section 245A of the Immigration and Nationality Act
Extension without change of a currently approved collection   No
Regular
Approved with change 03/30/2015
Retrieve Notice of Action (NOA) 01/28/2015
Approved for only two years due to partial GPEA compliance.
  Inventory as of this Action Requested Previously Approved
03/31/2017 36 Months From Approved 03/31/2015
60 0 60
70 0 70
11,250 0 0

This information collection will now be used to apply to U.S. Citizenship and Immigration Services (USCIS) for benefits pursuant to the terms and conditions of certain settlement agreements.

US Code: 8 USC 1255a Name of Law: Immigration and Nationality Act
  
None

Not associated with rulemaking

  79 FR 45829 08/06/2014
79 FR 68283 11/14/2014
Yes

  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 60 60 0 0 0 0
Annual Time Burden (Hours) 70 70 0 0 0 0
Annual Cost Burden (Dollars) 11,250 0 0 11,250 0 0
No
No

$36,450
No
No
No
No
No
Uncollected
Bosong Mayer 202 272-8356 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/28/2015


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