Affidavit of Support

Forms and Documents

Document Name	Status
Form I-134 Affidavit of Support Form	Modified
I-134 SS 20180605.docx Supporting Statement A	2018-08-28
privacy-pia-uscis-camino-may2015.pdf Supplementary Document	2016-02-22
Reference Citations.doc Supplementary Document	2016-02-22
DHS-USCIS-001 .pdf Supplementary Document	2016-02-22
DHS-USCIS-007.pdf Supplementary Document	2016-02-22
I-134 30-day FRN.pdf Supplementary Document	2018-08-02
I-134 60-day FRN.pdf Supplementary Document	2018-06-19

IC Document Collections

IC ID	Document Title	Status
20257	Affidavit of Support Form	Modified

ICR Details

OMB Control No: 1615-0014	ICR Reference No: 201806-1615-007
Status: Active	Previous ICR Reference No: 201602-1615-005
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-134
Title: Affidavit of Support
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/13/2019
	Date Received in OIRA: 11/30/2018
Terms of Clearance: Approved for two years only due to lack of GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	02/28/2019
Responses	2,500	0	18,460
Time Burden (Hours)	3,750	0	27,690
Cost Burden (Dollars)	10,625	0	69,225

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Abstract: U.S. Citizenship and Immigration Services (USCIS) uses this form to determine whether an applicant for a visa, adjustment of status, or entry to the United States may possibly be excludable on the ground that he or she is likely to become a public charge.

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Authorizing Statute(s): US Code: 8 USC 1184 Name of Law: United States Code
  

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:
	83 FR 14486	04/04/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 34859	07/23/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Affidavit of Support	I-134	Affidavit of Support

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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	2,500	18,460	0	0	-15,960	0
Annual Time Burden (Hours)	3,750	27,690	0	0	-23,940	0
Annual Cost Burden (Dollars)	10,625	69,225	0	0	-58,600	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 estimated hour burden for this information collection has decreased a result of a decrease in the estimated number of respondents. There are no changes to the form or instructions. The estimated cost burden for this information collection has decreased as a result of a decrease in the estimated number of respondents that more than offset an increase in the estimated costs. There are no changes to the form or instructions.

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Annual Cost to Federal Government: $161,625

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: 11/30/2018

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