Information Collection

Inter-Agency Record of Individual Requesting Change/Adjustment to or From A or G Status; or Requesting A, G. or NATO Dependent Employment Authorization

IC 20289 under ICR 201506-1615-011 · OMB 1615-0027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
I566-INS-OMBReview-05092016.pdf	Instruction
I-566 Inter-Agency Record of Individual Requesting Change/Adju I566-FRM-OMBReview-05092016.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Inter-Agency Record of Individual Requesting Change/Adjustment to or From A or G Status; or Requesting A, G. or NATO Dependent Employment Authorization

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 214

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
Instruction			I566-INS-OMBReview-05092016.pdf		Yes	No	Printable Only
Form	I-566	Inter-Agency Record of Individual Requesting Change/Adjustment to or From A or G Status; or Requesting A, G. or NATO Dependent Employment Authorization	I566-FRM-OMBReview-05092016.pdf		Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: USCIS Benefits Information System

FR Citation: 73 FR 56596

Number of Respondents: 5,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,800	0	5,800
Annual IC Time Burden (Hours)	8,236	0	8,236
Annual IC Cost Burden (Dollars)	710,500	710,500	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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