Application for Significant Public Benefit Entrepreneur and Instructions for Data Reporting Supplement

Forms and Documents

Document Name	Status
Form I-941 Application for Significant Public Benefit Entrepreneur Form	Modified
I-941 Supporting Statement Fee Rule 83C.docx Supporting Statement A	2019-11-29
I-941 83C.pdf Justification for No Material/Nonsubstantive Change	2019-11-05
I941-INS-TOC-2019FeeRule-10302019.docx Supplementary Document	2019-11-05
SORN DHS-USCIS-007 BIS.pdf Supplementary Document	2019-02-05
SORN DHS-USCIS-ICE-CBP-001.pdf Supplementary Document	2019-02-05
PIA DHS-USCIS-PIA-016 CLAIMS 3.pdf Supplementary Document	2019-02-05
citations.docx Supplementary Document	2016-08-25

IC Document Collections

IC ID	Document Title	Status
223185	Biometric Processing	Unchanged
218313	Application for Significant Public Benefit Entrepreneur Form	Modified

ICR Details

OMB Control No: 1615-0136	ICR Reference No: 201911-1615-003
Status: Historical Inactive	Previous ICR Reference No: 201901-1615-012
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-941
Title: Application for Significant Public Benefit Entrepreneur and Instructions for Data Reporting Supplement
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 06/09/2020
	Date Received in OIRA: 11/29/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	04/30/2022	04/30/2022
Responses	5,880	0	5,880
Time Burden (Hours)	17,258	0	17,258
Cost Burden (Dollars)	1,440,600	0	1,440,600

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Abstract: USCIS is submitting this request because DHS is proposing to require an alien seeking entrepreneur parole under its proposed rule, "Significant Public Benefit Parole for Entrepreneurs," to file Form I-941 and, when applicable, Form I-941A, to demonstrate that he or she meets the eligibility criteria for entrepreneur parole based on significant public benefit. Based on his or her grant of parole, the alien's dependent spouse and children will also be eligible to request this parole.

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Authorizing Statute(s): US Code: 8 USC 1182 Name of Law: INA - Inadmissable Aliens
  

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 52229	10/16/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 1193	02/01/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Biometric Processing
Application for Significant Public Benefit Entrepreneur	I-941	Application for Entrepreneur Parole

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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:

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Annual Cost to Federal Government: $3,777,900

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? No

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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: 11/29/2019

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