Information Collection

Application for Employment Authorization for Abused Nonimmigrant Spouse

IC 223940 under ICR 201610-1615-010 · OMB 1615-0137.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0137 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I-765V Application for Employment Authorization for Abused Nonimmigrant Spouse Application for Employment Authorization for Abused Nonimmigrant Spouse	Form
I765V-INS-OMBReview-01182017.pdf	Instruction
I-765V Application for Employment Authorization for Abused Noni I765V-FRM-OMBReview-01182017.pdf	Form

IC Title:

Application for Employment Authorization for Abused Nonimmigrant Spouse

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 274a.2(b)(1) 8 CFR 103.2(b)(9) 8 CFR 103.16 (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
Instruction				www.uscis.gov/i-765v	Yes	No	Printable Only
Form	I-765V			www.uscis.gov/i-765v	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: DHS/USCIS/ICE/CBP-001-Alien File, Index, and National File Tracking

FR Citation: 78 FR 69864

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	3,000	3,000
Annual IC Cost Burden (Dollars)	255,000	255,000

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.

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