USCIS Electronic Payment Processing

Burden Disclosure Notice

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information, unless it displays a currently
valid OMB control number. The public reporting burden for this collection of information is estimated at .167 hour or 5 minutes per response, including the time for
reviewing instructions and completing and submitting the authorization. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and
Strategy, 20 Massachusetts Ave, NW, Washington, DC 20529-2140; OMB No. 1615-0131. Do not mail your completed form to this address.

AUTHORITIES: 8 U.S.C. §§ 1103, 1356 and 8 CFR 103.7(b)(1)(i)(D) authorize the collection of this information.
PURPOSE: The primary purpose for providing the requested information is to authorize an electronic credit card or Automated Clearing House (ACH) payment in
Pay.gov, which is owned and operated by the Department of Treasury for payment of USCIS fees.
DISCLOSURE: The information you provide is voluntary. However, failure to pay the required filing or biometric services fees associated with your application, petition,
or request may delay acceptance or processing of your case. Failure to pay the USCIS fee may also delay production of any identity cards or other documents associated
with your application, petition, or request.
ROUTINE USES: This information may be used by and disclosed to USCIS personnel and contractors or others agents who need the information to assist in activities
related to processing required fees for applications, petitions, or requests, and proof of benefits. Additionally, USCIS may disclose the information to other federal,
state, and local authorized organizations, in accordance with approved routine used as described in the associated published system of records notice
[TREASURY/FMS.017 – Collections Records – Treasury/Financial Management Service, which can be found at http://www.treasury.gov/privacy, and DHS-USCIS-007 –
Benefits Information System, available at www.dhs.gov/privacy]. This information may also be made available as appropriate for law enforcement purposes or in the
interest of national security.

OMB No. 1615-0131
Expires 08/31/2018
*Indicates Required Field

USCIS Immigrant Fee

Credit card payment

USCIS Immigrant Fee

Credit card payment

USCIS Immigrant Fee

Credit card payment

USCIS Immigrant Fee

ACH payment

USCIS Immigrant Fee

ACH payment

USCIS Immigrant Fee

Congratulations. You successfully submitted an immigrant fee payment on
Thursday, December 10, 2015 at 10:27:55 AM for each immigrant listed in the
table below.
• Each immigrant listed should receive their Permanent Resident Card within 120
days of entry into the United States or within 120 days after the USCIS
Immigrant Fee is received, whichever occurred later.
• If they do not receive their Permanent Resident Card within the timeframe
stated above, please submit a follow-up inquiry with the Customer Contact
Center by filling out the online help form.