OMB Form 83C

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS-USCIS

0052
1615
___ ___
___ ___ - ___
___ ___ ___
Enter only items that change
Current record

New record

Agency form number (s)

N-400

Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%

Total annual hours
Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

USCIS Requests approval to extend the Term of Clearance allowing for the intake of the previous approved version of the
N-400 through October 1, 2016. The Director of USCIS is considering recommendations regarding the enforcement of the
new preparer and interpreter sections and requirements for stakeholders that conduct large group assistance form completion
events across the country.
Signature of Senior Official or designee:
Date:
For OIRA Use
Digitally signed by TYRONE O HUFF
___________________________________
DN: c=US, o=U.S. Government, ou=Department of
Homeland Security, ou=DHS HQ, ou=People, cn=TYRONE O
___________________________________
HUFF, 0.9.2342.19200300.100.1.1=0232801981.DHS HQ.2
8/5/2016

TYRONE O HUFF

Date: 2016.08.05 14:16:20 -04'00'

** This form cannot be used to extend an expiration date.

OMB 83-C

10/95