Special Immigrant Visa Supervisor Locator

Forms and Documents

Document Name	Status
Form DS-158 CONTACT INFORMATION AND WORK HISTORY FOR NONIMMIGRANT VISA APPLICANT Form and Instruction	Modified
FINAL - Supporting Statement - 7-31-2019.docx Supporting Statement A	2019-07-31
DS-158 Day Legal Authorities.docx Supplementary Document	2018-11-27

IC Document Collections

IC ID	Document Title	Status
43819	CONTACT INFORMATION AND WORK HISTORY FOR NONIMMIGRANT VISA APPLICANT Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0144	ICR Reference No: 201811-1405-002
Status: Active	Previous ICR Reference No: 201510-1405-018
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Special Immigrant Visa Supervisor Locator
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: 08/02/2019
	Date Received in OIRA: 11/27/2018
Terms of Clearance: Agency confirmed electronic submission via a fillable PDF. Small adjustments to burden estimation assumptions.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2022	36 Months From Approved	08/31/2019
Responses	150	0	2,000
Time Burden (Hours)	150	0	2,000
Cost Burden (Dollars)	0	0	0

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Abstract: Department of State uses Form DS-158 (Special Immigrant Visa Supervisor Locator) in order to assist applicants for special immigrant visa (SIV) applicants under section 602(b) of the Afghan Allies Protection Act of 2009 (Pub. L. 111-8), in attempting to locate an applicant's prior Department of Defense (DoD) supervisor. The information requested on the form is limited to that necessary to locate the supervisor through DoD and Veteran's Affairs, and if the location is successful will assist the applicant in the SIV application process.

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Authorizing Statute(s): US Code: 8 USC 1202 Name of Law: The Immigration and Nationality Act
   US Code: 8 USC 1182 Name of Law: The Immigration and Nationality Act
   US Code: 8 USC 1201 Name of Law: The Immigration and 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:
	83 FR 44403	08/30/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 60550	11/26/2018
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
CONTACT INFORMATION AND WORK HISTORY FOR NONIMMIGRANT VISA APPLICANT	DS-158	Special Immigrant Visa Supervisor Locator

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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	150	2,000	0	-1,850	0	0
Annual Time Burden (Hours)	150	2,000	0	-1,850	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: For fiscal year 2019, the Department estimates that 150 applicants will submit the DS-158. This number reflects an estimate based on the past three fiscal year receipts of the DS-158 by the Department. The previous estimates were not representative of the actual volume, thus this new estimate lowers the total hour burden from the previous submission.

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Annual Cost to Federal Government: $739

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.     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: 11/27/2018

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