N-565 83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS/USCIS

0091
1615
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Enter only items that change
Current record

New record

Agency form number (s)

N-565

Annual reporting and recordkeeping hour
burden
Number of respondents

27,690

27,690

Total annual responses

55,380

55,380

Percent of these responses
collected electronically
Total annual hours

0

%

69,225

33

%

65,451

Difference

-3,774

Explanation of difference

reduction due to e-filing capability

Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)

Adjustment

Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

USCIS previously submitted the electronic submission process for review and approval and now is submitting a non
substantive request to reflect the lesser time required to submit this version of the collection of information.
Signature of Senior Official or designee:

Date:

1/16/2020
** This form cannot be used to extend an expiration date.

OMB 83-C

For OIRA Use
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10/95