Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified	Available
I-102-Supporting Statement-Fee Rule-83C-NPRM.docx	Supporting Statement A	Uploaded 2019-11-14	Available
I-102 83C.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2019-11-12	Available
I102-FRM-TOC-30Day-REV-08152019.docx	Supplementary Document	Uploaded 2019-09-09	Available
SORN 018 DHS_USCIS IBBC 20180731.pdf	Supplementary Document	Uploaded 2019-09-09	Repair queued
I102-INS-TOC-2019FeeRule-10302019.docx	Supplementary Document	Uploaded 2019-11-12	Available
privacy-pia-016a-uscis-claims3-march25,2016.pdf	Supplementary Document	Uploaded 2017-08-11	Available
privacy-pia-003b-uscis-iddmp-feb28,2017.pdf	Supplementary Document	Uploaded 2017-08-11	Available
Reference Citation.docx	Supplementary Document	Uploaded 2017-08-21	Available
SORN 001 AFileIndexNFTS 2013 11 21.html	Supplementary Document	Uploaded 2017-08-11	Available
SORN 007 Benefits Info Sys 2016 10 19.pdf	Supplementary Document	Uploaded 2017-08-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
20403	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified

ICR Details

OMB Control No: 1615-0079	ICR Reference No: 201911-1615-027
Status: Historical Inactive	Previous ICR Reference No: 201909-1615-002
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-102
Title: Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
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OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/21/2019
	Date Received in OIRA: 11/27/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	4,100	0	4,100
Time Burden (Hours)	3,075	0	3,075
Cost Burden (Dollars)	1,182,440	0	1,182,440

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Abstract: An alien temporarily residing in the United States can use this form to request a replacement of his or her lost, stolen, mutilated arrival-departure document, or he or she may also request a new arrival-departure record, if one was not issued when he or she was last admitted as a nonimmigrant, and has not since been issued such record but is in need of one USCIS uses the information provided by the requester to verify eligibility, as well as his or her status, process the request and issue a new or replacement arrival-departure record.

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Authorizing Statute(s): US Code: 8 USC 1304 Name of Law: U.S. 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:
	84 FR 26422	06/06/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 46961	09/06/2019
Did the Agency receive public comments on this ICR? Yes

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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 Replacement/Initial Nonimmigrant Arrival-Departure Document	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

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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: $1,824,500

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: 11/27/2019

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