Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form EOIR 42A Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents	Form	Modified	Available
30-Day 84 FR 31627.pdf	Supplementary Document	Uploaded 2019-07-17	Available
EOIR-42 2019 60 day FR Notice.pdf	Supplementary Document	Uploaded 2019-06-26	Available
OMB Form 83i EOIR 42 2019.pdf	Supplementary Document	Uploaded 2019-06-26	Available
Legal Authority OMB1125-0001.pdf	Supplementary Document	Uploaded 2019-06-26	Available
EOIR-42 2019 30 day FR Notice.pdf	Supplementary Document	Uploaded 2019-06-26	Available
Draft EOIR-42B 2019 highligths.pdf	Supplementary Document	Uploaded 2019-06-26	Available
Draft EOIR-42A 2019 highlights.pdf	Supplementary Document	Uploaded 2019-06-26	Available
Supporting statement 2019 EOIR42 OMB1125-0001.pdf	Supporting Statement A	Uploaded 2019-06-26	Available
EOIR-42 2019 60 day FR Notice.pdf	Supplementary Document	Uploaded 2019-04-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
12667	Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents	Form	Modified

ICR Details

OMB Control No: 1125-0001	ICR Reference No: 201904-1125-002
Status: Active	Previous ICR Reference No: 201603-1125-002
Agency/Subagency: DOJ/EOIR	Agency Tracking No: EOIR-42ab
Title: Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/22/2020
	Date Received in OIRA: 07/17/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved	01/31/2020
Responses	27,999	0	25,654
Time Burden (Hours)	162,394	0	148,793
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is necessary to determine the statutory eligibility for cancellation of removal of individual aliens determined to be removable from the U.S. and to provide information relevent to a favorable exercise of discretion.

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Authorizing Statute(s): US Code: 8 USC 1229b Name of Law: IMMIGRATION AND NATIONALITY
  

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:
	84 FR 17891	04/26/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 31627	07/02/2019
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents	EOIR 42A, EOIR 42B	Application for Cancellation of Removal for Certain Permanent Residents ,   Application for Cancellation of Removal and Adjustment of Status for Certain Nonpermenant Residents

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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	27,999	25,654	0	2,345	0	0
Annual Time Burden (Hours)	162,394	148,793	0	13,601	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Our time and cost burdens increased due to an increase in the average number of responses received over the past three years.

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Annual Cost to Federal Government: $265,181

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: 07/17/2019

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