Affidavit of Support Under Section 213A of the Act

Forms and Documents

Document Name	Status
Form I-864 Affidvit of Support Under Section 213A of the Act Form	Modified
Form I-864W Affidavit of Support Under Section 213A of the Act Form	Modified
Form I-864EZ Affidavit of Support Under Section 213A of the Act Form	Modified
Form I-864A Affidavit of Support Under Section 213A of the Act Form	Modified
I-864 30-day FRN 20170630.pdf Supplementary Document	2017-07-05
Supporting Statement Appendix A.pdf Supplementary Document	2017-06-27
I864W-INS-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864W-FRM-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864EZ-INS-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864EZ-FRM-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864A-INS-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864A-FRM-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864-INS-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
I864W-FRM-TOC-30Day-06192017.docx Supplementary Document	2017-06-27
privacy-pia-016a-uscis-claims3-march25,2016.pdf Supplementary Document	2017-05-16
SORN 007 Benefits Info Sys 2016 10 19.pdf Supplementary Document	2017-06-27
SORN 001 AFileIndexNFTS 2013 11 21.html Supplementary Document	2017-05-16
I-864 60d FRN 20170314.pdf Supplementary Document	2017-05-16
71 FR 35732, 35739.doc Supplementary Document	2017-05-16
Dep of State Foreign Affairs Manual Volume 9-Visas.pdf Supplementary Document	2017-05-16
USCIS memo (Consolidation of Policy of USCIS Form I-864).pdf Supplementary Document	2017-05-16
Section 213A.doc Supplementary Document	2017-05-16
I-864 Supporting Statement (30d updated) (005).docx Supporting Statement A	2018-02-28

IC Document Collections

IC ID	Document Title	Status
41275	Affidvit of Support Under Section 213A of the Act Form	Modified
204187	Affidavit of Support Under Section 213A of the Act Form	Modified
204186	Affidavit of Support Under Section 213A of the Act Form	Modified
204184	Affidavit of Support Under Section 213A of the Act Form	Modified

ICR Details

OMB Control No: 1615-0075	ICR Reference No: 201705-1615-004
Status: Historical Active	Previous ICR Reference No: 201503-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-864
Title: Affidavit of Support Under Section 213A of the Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/06/2018
	Date Received in OIRA: 07/10/2017
Terms of Clearance: Approved for two years due to lack of GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved	03/31/2018
Responses	702,184	0	756,300
Time Burden (Hours)	3,138,208	0	3,265,650
Cost Burden (Dollars)	161,526,540	0	132,177,500

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Abstract: USCIS uses the data collected on Form I-864 to determine whether the sponsor has the ability to support the sponsored alien under section 213A of the Immigration and Nationality Act. This form standardizes evaluation of a sponsor’s ability to support the sponsored alien and ensures that basic information required to assess eligibility is provided by petitioners. Form I-864A is a contract between the sponsor and the sponsor’s household members. It is only required if the sponsor used the income of his or her household members to reach the required 125 percent of the Federal poverty guidelines. The contract holds these household members jointly and severally liable for the support of the sponsored immigrant. The information collection required on Form I-864A is necessary for public benefit agencies to enforce the Affidavit of Support in the event the sponsor used income of his or her household members to reach the required income level and the public benefit agencies are requesting reimbursement from the sponsor. USCIS uses Form I-864EZ in exactly the same way as Form I-864; however, less information is collected from the sponsors as less information is needed from those who qualify in order to make a thorough adjudication. USCIS uses Form I-864W to determine whether the intending immigrant meets the criteria for exemption of section 213A requirements. This form collects the immigrant’s basic information, such as name and address, the reason for the exemption, and accompanying documentation in support of the immigrant’s claim that they are not subject to section 213A.

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Authorizing Statute(s): US Code: 8 USC 1183a Name of Law: Immigration Nationality Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 13650	03/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 29913	06/30/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Affidvit of Support Under Section 213A of the Act	I-864	Affidavit of Support Under Section 213A of the INA
Affidavit of Support Under Section 213A of the Act	I-864W	Intending Immigrant's Affidavit of Support Exemption
Affidavit of Support Under Section 213A of the Act	I-864EZ	Affiavit of Support of Support Under Section 213A of the Act
Affidavit of Support Under Section 213A of the Act	I-864A	Contract Between Sponsor and Household Member

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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	702,184	756,300	0	0	-54,116	0
Annual Time Burden (Hours)	3,138,208	3,265,650	0	0	-127,442	0
Annual Cost Burden (Dollars)	161,526,540	132,177,500	0	0	29,349,040	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The total hour burden for this information collection has changed due to adjustments to the estimated number of respondents for each instrument in this information collection. The total cost burden for this information collection has changed due to adjustments to the estimated number of respondents for each instrument in this information collection. In addition, USCIS is now reporting a cost for the I-864W because it is filed as a standalone form and has its own processing costs, which were not captured at the time of the last submission. There were, however, no impacts to the average burden per response as a result of the changes made to the information collection instruments that are part of this IC.

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Annual Cost to Federal Government: $26,380,680

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 07/10/2017

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