Previous terms
of clearance continue to apply. USCIS may continue to use the
previous version of the instrument until December 23, 2016.
Inventory as of this Action
Requested
Previously Approved
03/31/2017
03/31/2017
03/31/2017
20,725
0
20,725
36,211
0
36,211
7,657,031
0
7,657,031
The information collected on this form
is used by the U.S. Citizenship and Immigration Services (USCIS) to
determine whether the applicant is eligible for a waiver of
excludability under section 212 of the Act.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.