Genealogy Index Search Request and Genealogy Records Request

Forms and Documents

Document Name	Status
Form G-1041 Genealogy Index Search Request (Electronic) Form and Instruction	Removed
Form G-1041A Genealogy Records Request Form	Modified
Form G-1041A Genealogy Records Request (Electronic) Form and Instruction	Removed
G-1041A-INS-OMB-TOC-03152016 highlighted.docx Supplementary Document	2016-03-25
G-1041A-FRM-OMB-TOC-03152016 highlighted.docx Supplementary Document	2016-03-25
G-1041-INS-OMB-TOC-03152016 highlighted.docx Supplementary Document	2016-03-25
G1041-FRM-OMB-TOC-03152016 highlighted.docx Supplementary Document	2016-03-25
G-1041A-INS-OMB-TOC-03152016.docx Supplementary Document	2016-03-25
G-1041A-FRM-OMB-TOC-03152016.docx Supplementary Document	2016-03-25
G-1041-INS-OMB-TOC-03152016.docx Supplementary Document	2016-03-25
G1041-FRM-OMB-TOC-03152016.docx Supplementary Document	2016-03-25
1615-0096_Supporting Statement 1615-0096 G-1041 G-1041A 05 19 16.doc Supporting Statement A	2016-05-19
30-day FRN 12 23 15.pdf Supplementary Document	2015-12-23
60 Day FRN G-1041& 1041A 08 04 15.pdf Supplementary Document	2015-10-08
privacy_pia_cis_midas.pdf Supplementary Document	2015-10-08
DHS USCIS-001-Alien File, Index, and Natioal File Tracking System of Records.pdf Supplementary Document	2015-10-08
USCODE-2011-title8-chap12-subchapII-partIX-sec1356.pdf Supplementary Document	2015-10-08
References.doc Supplementary Document	2015-10-08

IC Document Collections

IC ID	Document Title	Status
20431	Genealogy Index Search Request (Electronic) Form and Instruction	Removed
202018	Genealogy Records Request Form	Modified
202017	Genealogy Records Request (Electronic) Form and Instruction	Removed
202016	Genealogy Index Search Request Instruction	Modified

ICR Details

OMB Control No: 1615-0096	ICR Reference No: 201510-1615-004
Status: Historical Active	Previous ICR Reference No: 201204-1615-002
Agency/Subagency: DHS/USCIS	Agency Tracking No: G-1041 and G-1041A
Title: Genealogy Index Search Request and Genealogy Records Request
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: 05/19/2016
	Date Received in OIRA: 12/30/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	6,860	0	6,156
Time Burden (Hours)	3,430	0	3,079
Cost Burden (Dollars)	25,726	0	0

---

Abstract: The Genealogy Program is necessary to provide a more timely response to requests for genealogical and historical records. Form G-1041 is provided as a convenient means for persons to provide data necessary to perform a search of historical agency indices. Form G-1041A provides a convenient means for persons to identify a particular record desired under the Genealogy Program. The forms provide rapid identification of such requests and ensures expeditious handling. Persons such as researchers, historians, and social scientists seeking ancestry information for genealogical, family history and heir location purposes will use Forms G-1041 and G-1041A.

---

Authorizing Statute(s): US Code: 8 USC 1356 Name of Law: U.S. Code
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 46315	08/04/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 79923	12/23/2015
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Genealogy Index Search Request	G-1041	Genealogy Index Search Request,
Genealogy Records Request	G-1041A	Genealogy Records Request
Genealogy Index Search Request (Electronic)	G-1041	Genealogy Records Request
Genealogy Records Request (Electronic)	G-1041A	Genealogy Records Request

---

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	6,860	6,156	0	-4,253	4,957	0
Annual Time Burden (Hours)	3,430	3,079	0	-2,127	2,478	0
Annual Cost Burden (Dollars)	25,726	0	0	0	25,726	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There has been an increase of 351 burden hours with respect to the total burden hours previously reported for this information collection. This change can be attributed to a projected increase in the estimated number of respondents from 6,156 respondents to 6,860 based on updated statistical projection data. Additionally, USCIS is revising this information collection by making changes to the instructions and forms 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.During the previous submission, no out-of-pocket expenses were calculated. There has been an increase of $3,187.5 annual cost burden which accounts for the out-of-pocket cost that respondents may incur .

---

Annual Cost to Federal Government: $205,352

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

---

Common Form ICR:  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:

(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: 12/30/2015

---