Application for Employment Authorization

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-765WS I-765 Worksheet	Form and Instruction	Modified	Available
Form I-765 Application for Employment Authorization	Form	Modified	Available
I-765 60-day Public Comment Responses - Final.docx	Supplementary Document	Uploaded 2018-02-15	Available
I-765 30-day FRN 20180208.pdf	Supplementary Document	Uploaded 2018-02-09	Available
I-765 60-day FRN 20171013.pdf	Supplementary Document	Uploaded 2018-02-09	Available
I765WS-FRM-TOC-Comp-OMBReview-05222018.docx	Supplementary Document	Uploaded 2018-05-30	Available
I765-INS-TOC-Comp-OMBReview-05222018.docx	Supplementary Document	Uploaded 2018-05-30	Available
I765-FRM-TOC-Comp-OMBReview-05222018.docx	Supplementary Document	Uploaded 2018-05-30	Available
SORN 010 Asy&PreScreen 2015 11 30.html	Supplementary Document	Uploaded 2018-02-09	Available
SORN 007 Benefits Info Sys 2016 10 19.pdf	Supplementary Document	Uploaded 2018-02-09	Available
SORN 001 AFileIndexNFTS 2017 09 18.pdf	Supplementary Document	Uploaded 2018-02-09	Available
privacy-pia-061-uscis-benefitrequestintakeprocess-march15,2016.pdf	Supplementary Document	Uploaded 2018-02-09	Available
privacy-pia-056-uscis-eliseappendixaupdate-may17,2016.pdf	Supplementary Document	Uploaded 2018-02-09	Available
privacy-pia-027(c)-uscis-asylum-july21,2017.pdf	Supplementary Document	Uploaded 2018-02-09	Available
privacy-pia-016a-uscis-claims3-march25,2016.pdf	Supplementary Document	Uploaded 2018-02-09	Available
privacy-pia-003b-uscis-iddmp-feb28,2017.pdf	Supplementary Document	Uploaded 2018-02-09	Available
PTA, USCIS- Form I-765, 20170922, PRIV final.pdf	Supplementary Document	Uploaded 2018-02-09	Available
I-765-SS-Final-20180524.docx	Supporting Statement A	Uploaded 2018-05-30	Available
SSA SORN 60-058 79FR8780_13FEB2014.pdf	Supplementary Document	Uploaded 2017-02-15	Available
SSA SORN 60-058 78FR40542_5JUL2013.pdf	Supplementary Document	Uploaded 2017-02-15	Available
SSA SORN 60-058 75FR82121_29DEC2010.pdf	Supplementary Document	Uploaded 2017-02-15	Available
Reference citations_FRM I765.doc	Supplementary Document	Uploaded 2018-02-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
203680	Passport-Style Photographs		Modified
203678	I-765 Worksheet	Form and Instruction	Modified
203677	Biometric Processing		Modified
20321	Application for Employment Authorization	Form	Modified

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201802-1615-001
Status: Historical Active	Previous ICR Reference No: 201712-1615-005
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-765, I-765WS
Title: Application for Employment Authorization
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: 05/31/2018
	Date Received in OIRA: 02/28/2018
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2018
Responses	4,276,299	0	4,939,993
Time Burden (Hours)	10,550,549	0	8,997,383
Cost Burden (Dollars)	367,575,520	0	651,308,752

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Abstract: USCIS will use the information collected to determine eligibility for work authorization and for the issuance of an employment authorization document.

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Authorizing Statute(s): US Code: 8 USC 1153 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 47761	10/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 5643	02/08/2018
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Employment Authorization	I-765	Application for Employment Authorization Document
Biometric Processing
I-765 Worksheet	I-765WS	Form I-765 Worksheet
Passport-Style Photographs

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ICR Summary of Burden

table that charts list 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	4,276,299	4,939,993	0	0	-663,694	0
Annual Time Burden (Hours)	10,550,549	8,997,383	0	0	1,553,166	0
Annual Cost Burden (Dollars)	367,575,520	651,308,752	0	0	-283,733,232	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: There has been an increase in the estimated annual hour burden for this collection of information due to an increase in the average time burden per response. USCIS increased the estimated time per response from 3.42 hours to 4.5 hours to account for the addition of new questions on the form and new language in the instructions. There has been a decrease in the estimated annual cost burden for this information collection. USCIS has decreased this estimate because Form I-765 is filed concurrently with a number of other USCIS forms, and therefore many of the costs associated with filing the I-765 would be covered under the primary form filed by the respondent.

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Annual Cost to Federal Government: $862,962,895

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.     Yes

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.     Yes

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: 02/28/2018

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