Application for Significant Public Benefit Entrepreneur and Instructions for Data Reporting Supplement

Forms and Documents

Document Name	Status
Form I-941 Application for Significant Public Benefit Entrepreneur Form	Modified
I-941 SS 2017-1-17.doc Supporting Statement A	2017-01-17
citations.docx Supplementary Document	2016-08-25
PIA 016.pdf Supplementary Document	2016-08-25
DHS USCIS SORN 007.docx Supplementary Document	2016-08-05
DHS USCIS SORN 001.docx Supplementary Document	2016-08-05

IC Document Collections

IC ID	Document Title	Status
223185	Biometric Processing	Unchanged
218313	Application for Significant Public Benefit Entrepreneur Form	Modified

ICR Details

OMB Control No: 1615-0136	ICR Reference No: 201701-1615-011
Status: Historical Active	Previous ICR Reference No: 201509-1615-006
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-941
Title: Application for Significant Public Benefit Entrepreneur and Instructions for Data Reporting Supplement
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/18/2017
	Date Received in OIRA: 01/17/2017
Terms of Clearance: Approved for two years only due to partial GPEA compliance. USCIS may begin collecting this information no earlier than either July 17, 2017 or the effective date of the International Entrepreneur Final Rule.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2019	36 Months From Approved
Responses	5,880	0	0
Time Burden (Hours)	17,258	0	0
Cost Burden (Dollars)	1,440,600	0	0

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Abstract: USCIS is submitting this request because DHS is proposing to require an alien seeking entrepreneur parole under its proposed rule, "Significant Public Benefit Parole for Entrepreneurs," to file Form I-941 and, when applicable, Form I-941A, to demonstrate that he or she meets the eligibility criteria for entrepreneur parole based on significant public benefit. Based on his or her grant of parole, the alien's dependent spouse and children will also be eligible to request this parole.

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Authorizing Statute(s): US Code: 8 USC 1182 Name of Law: INA - Inadmissable Aliens
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1615-AC04	Final or interim final rulemaking	82 FR 5238	01/17/2017

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Application for Significant Public Benefit Entrepreneur	I-941	Application for Significant Public Benefit Entrepreneur
Biometric Processing

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,880	0	0	2,940	2,940	0
Annual Time Burden (Hours)	17,258	0	0	3,440	13,818	0
Annual Cost Burden (Dollars)	1,440,600	0	0	0	1,440,600	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Package is being submitted with final rule

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Annual Cost to Federal Government: $3,777,900

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/17/2017

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