E-Verify Self Check - Further Action Pursued

myE-Verify Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0117 can be found here:

Documents and Forms

Document Name Document Type
E-Verify Self Check - Further Action Pursued Form and Instruction
Self Check Content Document 1a. PRA_SelfCheck Content Document for PRA.docx Form and Instruction
Self Check Wireframes 1b. Self Check Wireframes_for PRA.PDF Form and Instruction
Self Check Content Document_ScreenShots 7-22-14.docx E-Verify Self-Check Screenshots (Comprehensive) IC Document

Information Collection (IC) Details

IC Title:	E-Verify Self Check - Further Action Pursued	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Self Check Content Document	1a. PRA_SelfCheck Content Document for PRA.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Self Check Wireframes	1b. Self Check Wireframes_for PRA.PDF		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: DHS/USCIS-013 E-Verify Self-Check	FR Citation: 76 FR 9034

Number of Respondents: 10,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10,000	4,418	5,582
Annual IC Time Burden (Hours)	11,830	5,226	6,604
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
E-Verify Self-Check Screenshots (Comprehensive)	Self Check Content Document_ScreenShots 7-22-14.docx	07/24/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.