1615-0096_Supporting Statement 1615-0096 G-1041 G-1041A 05 19 16

SUPPORTING STATEMENT FOR

GENEOLOGY INDEX SEARCH REQUEST AND GENEOLOGY RECORDS REQUEST

OMB Control No.: 1615-0096

COLLECTION INSTRUMENT(S): Forms No. G-1041 and G-1041A.

A. Justification

1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

Section 112 of Public Law 106-553 (Making Appropriations for the Government of the District of Columbia and Other Activities Chargeable in Whole or in Part Against the Revenues of Said District of Columbia for the Fiscal Year Ending September 30, 2001 and for Other Purposes), established a Genealogy Fee for providing genealogy research and information services under section 286(t) of the Immigration and Nationality Act (Act). A Genealogy Program is necessary to provide a more timely response to requests for genealogical and historical records.

2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

Under Public Law 106-553, the U.S. Citizenship and Immigration Services (USCIS) charges a fee to recover the cost of searching for and identifying the presence or absence of an historical record. USCIS additionally charges a second set of fees to retrieve, copy, review, and mail historical records to requesters. There is a fee for a copy of a microfilmed record and a separate fee for a copy of a textual record. USCIS uses the data collected on these forms to determine eligibility for the requested service. The forms serve the purpose of standardizing requests for the benefit, and ensuring that basic information is required to assess eligibility provided by applicants.

The Genealogy Index Search Request, Form G-1041, is provided as a convenient means for customers to provide data necessary to perform a search of historical agency indices. The Genealogy Records Request, Form G-1041A, provides a convenient means for customers to identify a particular record desired under the Genealogy Program. The forms provide rapid identification of such requests and ensure expeditious handling.

Customers 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. United States citizens seeking historical records to support a foreign application for dual citizenship may also use the forms.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

The use of these forms provides the most efficient means for collecting and processing the required data. Forms G-1041 and G-1041A are both available on the USCIS website (http://www.uscis.gov/g-1041 and http://www.uscis.gov/g-1041a); they can be completed online but they cannot be e-filed. The filing fee must be submitted through the USCIS online filing system on the USCIS Website. Respondents will be directed to make their fee payment via the collection approved at 1615-0131 (USCIS Electronic Payment Processing). 

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

A review of USCIS’ Forms Inventory Report revealed no duplication of effort, and there is no other similar information currently available that can be used for this purpose.

5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.

This collection of information does not have an impact on small businesses or other small entities.

6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

This form was created to facilitate an accurate and timely response to USCIS Genealogy Program requests. If the information is not collected, a response to such requests may be impossible or unduly delayed.

7. Explain any special circumstances that would cause an information collection to be conducted in a manner:

• Requiring respondents to report information to the agency more often than quarterly;

• Requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

• Requiring respondents to submit more than an original and two copies of any document;

• Requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;

• In connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;

• Requiring the use of a statistical data classification that has not been reviewed and approved by OMB;

• That includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

• Requiring respondents to submit proprietary trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.

This information collection is conducted in a manner consistent with the guidelines in 5 CFR 1320.5(d)(2).

8. If applicable, provide a copy and identify the data and page number of publication in the Federal Register of the agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.

Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping, disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or reported.

Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years - even if the collection of information activity is the same as in prior periods. There may be circumstances that may preclude consultation in a specific situation. These circumstances should be explained.

On August 4, 2015 USCIS published a 60-day notice in the Federal Register at 80 FR 46315. USCIS did not receive comments after publishing that notice. On December 23, 2015, USCIS published a 30-day notice in the Federal Register at 80 FR 79923. USCIS did not receive comments.

9. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.

USCIS does not provide any payment for benefit sought.

10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation or agency policy.

There is no assurance of confidentiality. This information collection is covered by the Privacy Impact Analysis DHS/USCIS/PIA-017 Microfilm Digitization Application System (MiDAS) dated September 15, 2008 and the Privacy Act system of record notice DHS/USCIS—001 Alien File, Index, and National File Tracking System of Records, published in the Federal Register on November 21, 2013 at 78 FR 69864.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

There are no questions of a sensitive nature.

12. Provide estimates of the hour burden of the collection of information. The statement should:

• Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices.

• If this request for approval covers more than one form, provide separate hour burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-I.

• Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 14.

Type of Respondent	Form Name / Form Number	No. of Respondents	No. of Responses per Respondent	Avg. Burden per Response (in hours)	Total Annual Burden (in hours)	Avg. Hourly Wage Rate	Total Annual Respondent Cost
Individuals or Households.	Genealogy Index Search Request, Form G-1041	4,550	1	0.5	2,275	$31.79	$72,322.25
Individuals or Households.	Genealogy Records Request, Form G-1041A	2,310	1	0.5	1,155	$31.79	$36,717.45
Total		6,860			3,430		$109,039.70

* The above Average Hourly Wage Rate is the May 2014 Bureau of Labor Statistics average wage for “All Occupations” of $22.71 times the wage rate benefit multiplier of 1.4 (to account for benefits provided) equaling $31.79. “The selection of “All Occupations” was chosen as the expected respondents for this collection could be expected to be from any occupation.”*

13. Provide an estimate of the total annual cost burden to respondents or record keepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14).

• The cost estimate should be split into two components: (a) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance and purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities.

• If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.

• Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995; (2) to achieve regulatory compliance with requirements not associated with the information collection; (3) for reasons other than to provide information or keep records for the government; or, (4) as part of customary and usual business or private practices.

There are no capital or start-up costs associated with this information collection.

For informational purposes, USCIS offers that there is an estimated annual fee cost is

$157,990.

G-1041 - $91,000 - The number of respondents 4,550 x $20 fee charged; plus

G-1041A - $66,990 - The number of respondents 2,310 x $29 fee charged.

USCIS estimates that respondents will incur an estimated cost of $3.75 average postage

cost to each respondent to submit the completed package to USCIS. Postage to mail

completed package (6,860 x $3.75 average postage) = $25,726.

G-1041-$17,062.50-The number of respondents 4,550 x $3.75 postage cost; plus

G-1041A- $8,662.50-The number of respondents 2,310 x$3.75 postage cost.

14. Provide estimates of annualized cost to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a single table.

Annualized Cost Analysis: G-1041 G-1041A

1. Printing Cost $ 0 $ 0

2. Collection and Processing Cost $ 105,560 $ 99,792

3. Total Cost to Government $ 105,560 $ 99,792

Government Cost

The estimated annual cost to the Government is $205,352 ($105,560 + $99,792). This figure is calculated by:

• Multiplying 4,550, the estimated number of G-1041 respondents that submit the request by mail, x .58 hour (time required to collect and process information) x $40 (suggested average hourly rate for clerical, officer, and supervisory time with benefits); PLUS

• Multiplying, 2,310, the estimated number of G-1041A respondents that submit the request by mail, x 1.08 hour (time required to collect and process information) x $40(suggested average hourly rate for clerical, officer, and supervisory time with benefits).

15. Explain the reasons for any program changes or adjustments reporting in Items 13 or 14 of the OMB Form 83-I.

Data collection Activity/Instrument	Program Change (hours currently on OMB Inventory)	Program Change (New)	Difference	Adjustment (hours currently on OMB Inventory)	Adjustment (New)	Difference
G-1041				1825	2275	+450
G-1041A				1254	1155	-99
Total(s)				3,079	3,430	351

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 for FY 2015 and the resulting adjustment in agency estimates. 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.

Data collection Activity/Instrument	Program Change (cost currently on OMB Inventory)	Program Change (New)	Difference	Adjustment (cost currently on OMB Inventory)	Adjustment (New)	Difference
G-1041				0	$1,365	+$1,365
G-1041A				0	$1,823	+$1,825
Total(s)				0	$3,188	+$3,188

During the previous submission, no out-of-pocket expenses were calculated. There has been an increase of $3,188 annual cost burden which accounts for the out-of-pocket cost that respondents may incur as described under item 13 above.

16. For collections of information whose results will be published, outline plans for tabulation, and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.

This information collection will not be published for statistical purposes.

17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.

USCIS will display the expiration date for OMB approval of this information collection.

18. Explain each exception to the certification statement identified in Item 19, “Certification for Paperwork Reduction Act Submission,” of OMB 83-I.

USCIS does not request an exception to the certification of this information collection.

B. Collections of Information Employing Statistical Methods.

There is no statistical methodology involved with this collection.

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