Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents

Forms and Documents

Document Name	Status
Form EOIR 42A Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents Form	Unchanged
E-42A and 42B narrative, Zip Code Change.docx Justification for No Material/Nonsubstantive Change	2015-07-16
Memo to Lynn Murray.pdf Supplementary Document	2014-05-21
Published 60 day FR Notice.pdf Supplementary Document	2014-05-21
Published 30 FR Notice.pdf Supplementary Document	2014-05-21
Law or Authority mandating IC.pdf Supplementary Document	2014-05-21
Written Narrative of Proposed Changes.pdf Supplementary Document	2014-05-21
Certification Statement.pdf Supplementary Document	2014-05-21
OMB Form 83-I.pdf Supplementary Document	2014-05-21
1125-0001_Supporting_statement_final_052914.doc Supporting Statement A	2014-05-29

IC Document Collections

IC ID	Document Title	Status
12667	Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents Form	Unchanged

ICR Details

OMB Control No: 1125-0001	ICR Reference No: 201507-1125-002
Status: Historical Active	Previous ICR Reference No: 201405-1125-004
Agency/Subagency: DOJ/EOIR	Agency Tracking No: EOIR-42ab
Title: Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/20/2015
	Date Received in OIRA: 07/16/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	07/31/2016	07/31/2016
Responses	34,815	0	34,815
Time Burden (Hours)	202,971	0	202,971
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is necessary to determine the statutory eligibility for cancellation of removal of individual aliens determined to be removable from the U.S. and to provide information relevent to a favorable exercise of discretion.

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Authorizing Statute(s): US Code: 8 USC 1229b Name of Law: IMMIGRATION AND NATIONALITY
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 14734	03/17/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 28551	05/16/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents	EOIR 42A, EOIR 42B	Application for Cancellation of Removal for Certain Permanent Residents ,   Application for Cancellation of Removal and Adjustment of Status for Certain Nonpermenant Residents

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ICR Summary 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	34,815	34,815	0	0	0	0
Annual Time Burden (Hours)	202,971	202,971	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Agency adjustment due to an increase in the number of respondents.

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Annual Cost to Federal Government: $222,437

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

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Common Form ICR:  No

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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: 07/16/2015

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