Application for Employment Authorization for Abused Nonimmigrant Spouse

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0137 can be found here:

Documents and Forms

Document Name Document Type
I765V-INS-REV-30Day-11142017.pdf www.uscis.gov/i-765v Instruction
I-765V Application for Employment Authorization for Abused Noni I765V-FRM-REV-30Day-11142017.pdf www.uscis.gov/i-765v Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Employment Authorization for Abused Nonimmigrant Spouse	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 274a.2(b)(1) 8 CFR 103.2(b)(9) 8 CFR 103.16 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			I765V-INS-REV-30Day-11142017.pdf	www.uscis.gov/i-765v	Yes	No	Printable Only
Form	I-765V	Application for Employment Authorization for Abused Nonimmigrant Spouse	I765V-FRM-REV-30Day-11142017.pdf	www.uscis.gov/i-765v	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: DHS/USCIS/ICE/CBP-001-Alien File, Index, and National File Tracking	FR Citation: 78 FR 69864

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	-500	1,000
Annual IC Time Burden (Hours)	1,875	-1,125	3,000
Annual IC Cost Burden (Dollars)	125,000	-130,000	255,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.