Information Collection

Application for Employment Authorization (electronic)

IC 221225 under ICR 201604-1615-005 · OMB 1615-0040.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0040 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I-765 Electronic Application for Employment Authorization (electronic)	Form and Instruction
I-765 Electronic Application for Employment Authorization TPS 2016-4-21.pdf	Form and Instruction

IC Title:

Application for Employment Authorization (electronic)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 274a.13 (To search for a specific CFR, visit the Code of Federal Regulations.)

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
Form and Instruction	I-765 Electronic	Application for Employment Authorization	TPS 2016-4-21.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Electronic immigration System 3 - Autmoated Background

FR Citation: 76 FR 70735

Number of Respondents: 102,455

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	102,455	102,455
Annual IC Time Burden (Hours)	324,782	324,782
Annual IC Cost Burden (Dollars)	30,121,770	30,121,770

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.