Notice of Appeal of Decision Under Section 210 or 245A of the Immigration and Nationality Act

Forms and Documents

Document Name	Status
Form Form I-694 Notice of Appeal of Decision Under Section 210 or 245A of the Immigration and Nationality Act Form	Modified
I694-INS-TOC-OMBReview-03012016.docx Supplementary Document	2016-03-09
I694-INS-TOC-OMBReview-03012016 (Highlights).docx Supplementary Document	2016-03-09
I694-FRM-TOC-OMBReview-03012016.docx Supplementary Document	2016-03-09
I694-FRM-TOC-OMBReview-03012016 (Highlights).docx Supplementary Document	2016-03-09
1615-0034_Supporting Statement A 12 21 15.doc Supporting Statement A	2015-12-21
30-day Notice.pdf Supplementary Document	2015-11-04
I694-FRM-WIP-TOC-12182015.docx Supplementary Document	2015-12-21
I694-INS-WIP-TOC-12182015.docx Supplementary Document	2015-12-21
DHS-USCIS-007- Benefits Information System.docx Supplementary Document	2015-10-13
60-Day FRN 06 02 15.pdf Supplementary Document	2015-08-24
PTA USCIS-Form I-694 20100713 FINAL.pdf Supplementary Document	2015-08-24
privacy_pia_cis_claims3.pdf Supplementary Document	2015-08-24
Reference Citation.doc Supplementary Document	2015-08-24
DHS-USCIS-001-Alien File, Index, and National File Tracking System of Records.docx Supplementary Document	2015-10-13

IC Document Collections

IC ID	Document Title	Status
20308	Notice of Appeal of Decision Under Section 210 or 245A of the Immigration and Nationality Act Form	Modified

ICR Details

OMB Control No: 1615-0034	ICR Reference No: 201508-1615-003
Status: Historical Active	Previous ICR Reference No: 201207-1615-004
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-694
Title: Notice of Appeal of Decision Under Section 210 or 245A of the Immigration and Nationality Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/29/2016
	Date Received in OIRA: 12/23/2015
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	36 Months From Approved	03/31/2016
Responses	50	0	50
Time Burden (Hours)	75	0	25
Cost Burden (Dollars)	6,313	0	0

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Abstract: This form is used in considering appeals of denials of temporary and permanent residence status by legalization applicants and special agricultural workers under sections 210 and 245A of the Immigration and Nationality Act.

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Authorizing Statute(s): US Code: 8 USC 1255a Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1160 Name of Law: Immigration and Nationality Act
  

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:
	80 FR 31411	06/02/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 63579	10/20/2015
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
Notice of Appeal of Decision Under Section 210 or 245A of the Immigration and Nationality Act	Form I-694	Notice of Appeal of Decision Under Section 210 or 245A

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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	50	50	0	0	0	0
Annual Time Burden (Hours)	75	25	0	0	50	0
Annual Cost Burden (Dollars)	6,313	0	0	6,313	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: There has been an increase of 50 burden hours with respect to the total burden hours previously reported for this information collection. This change can be attributed to USCIS revising this information collection by making changes to the instructions and form to improve the overall organization of its content and provide clarity. Standardized language has also been added to conform to USCIS forms’ general common language. USCIS has also adjusted the cost to respondents by reporting the cost incurred by respondents in connection with this type of request. The cost previously reported was related to the Government Cost, which was $0. The new cost to respondents is estimated at $6,313.

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Annual Cost to Federal Government: $38,069

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: 12/23/2015

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