I-941 Instructions TOCs

TABLE OF CHANGES – INSTRUCTIONS

Form I-941, Application for Entrepreneur Parole

OMB Number: 1615-0136

01/30/2019

Reason for Revision: Include changes to Privacy Act Statement

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 01/31/2019

Edition Date 12/22/17 N

Current Page Number and Section	Current Text	Proposed Text
Page 17, USCIS Privacy Act Statement	[Page 17] USCIS Privacy Act Statement AUTHORITIES:  The information requested on this form, and the associated evidence, is collected pursuant to sections Section 402(4) of the Homeland Security Act of 2002 (HSA), Public Law 107-296, 116 Stat. 2135, 6 U.S.C. 202(4); Sections 103(a)(1) and (3) of the Immigration and Nationality Act (INA), 8 U.S.C. 1103(a)(1),(3); Section 274A(h)(3)(B) of the INA, 8 U.S.C. 1324a(h)(3)(B); and, Section 101(b)(1)(F) of the HSA, 6 U.S.C. 111 (b)(1)(F).   PURPOSE:  The primary purpose for providing the requested information on this form is to determine your eligibility for significant public benefit parole.  The information you provide will be used to grant or deny your request for public benefit parole.  DISCLOSURE:  The information you provide is voluntary.  However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in denial of your request for public benefit parole.  ROUTINE USES:  The information you provide on this form may be shared with other federal, state, local, and foreign government agencies in accordance with approved routine uses, as described in the associated published system of records notices [DHS/USCIS-007 - Benefits Information System and DHS/USCIS-001 - Alien File, Index, and National File Tracking System] which can be found at www.dhs.gov/privacy.  The information may also be made available, as appropriate for law enforcement purposes or in the interest of national security.	[Page 17] DHS Privacy Notice AUTHORITIES: The information requested on this application, and the associated evidence, is collected under the Immigration and Nationality Act (INA) sections 103(a)(1) and (3), 8 U.S.C. 1103(a)(1), (3); INA 274A(h)(3)(B), 8 U.S.C. 1324a(h)(3)(B); INA 212(d)(5), 8 U.S.C. 1182(d)(5); and sections 101(b)(1)(F) and 402(4) of the Homeland Security Act. PURPOSE: DHS uses the information you provide on this application to determine whether you meet the criteria for consideration for significant public benefit parole as an entrepreneur and otherwise merit a favorable exercise of DHS’ parole authority. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in denial of your application. ROUTINE USES: DHS may share the information you provide on this application and any additional requested evidence with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking System and DHS/USCIS-007 - Benefits Information System] and the published privacy impact assessments [DHS/USCIS/PIA-016a Computer Linked Application Information Management System 3 and Associated Systems] which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security.

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