Interagency Alien Witness and Informant Record

Forms and Documents

Document Name	Status
Form I-854B Agency Alien Witness and Informant Adjustment of Status Form	Modified
Form I-854A Interagency Alien Witness and Informant Record Form	Modified
I854AB-004-INS-TOC-EXT-OMBReview-08262021.docx Supplementary Document	2021-08-26
I-854AB EXT Supporting Statement 20210105.docx Supporting Statement A	2021-08-12
I-854A-B-004_86_FR_36568_2021-14707.pdf Supplementary Document	2021-08-04
I-854A-B 004_EXT_60-Day_85_FR_14468_2021-05393.pdf Supplementary Document	2021-06-22
Reference Citations.doc Supplementary Document	2017-05-24
SORN -A-File.pdf Supplementary Document	2017-05-22
PIA-013-01.pdf Supplementary Document	2017-05-22

IC Document Collections

IC ID	Document Title	Status
212234	Agency Alien Witness and Informant Adjustment of Status Form	Modified
20332	Interagency Alien Witness and Informant Record Form	Modified

ICR Details

OMB Control No: 1615-0046	ICR Reference No: 202106-1615-005
Status: Received in OIRA	Previous ICR Reference No: 201905-1615-006
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-854
Title: Interagency Alien Witness and Informant Record
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/01/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2021
Responses	40	136
Time Burden (Hours)	60	300
Cost Burden (Dollars)	0	0

---

Abstract: The Form I-854 will enable the U.S. Immigration and Customs Enforcement (ICE) to fulfill those responsibilities. A law enforcement agency may request S nonimmigrant classification for an essential witness or informant by completing this form, which requires certifications by both the law enforcement agency (e.g., that it will collect the alien's statutorily-required quarterly reports and oversee the alien's departure, if that becomes necessary) and the alien. The law enforcement agency files a properly completed Form I-854 with the Criminal Division, Department of Justice, which may certify the law enforcement agency request to the U.S. Citizenship and Immigration Services (USCIS).

---

Authorizing Statute(s): US Code: 8 USC 1101 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14468	03/16/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 36568	07/12/2021
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Agency Alien Witness and Informant Adjustment of Status	I-854B	Agency Alien Witness and Informant Adjustment of Status
Interagency Alien Witness and Informant Record	I-854A	Interagency Alien Witness and Informant Record

---

ICR Summary of Burden

	Total Request	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	40	136	0	0	-96	0
Annual Time Burden (Hours)	60	300	0	0	-240	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: The decrease in the estimated annual hour burden is due to a decrease in the estimated number of respondents. The annual total cost burden remained unchanged. There are no program changes.

---

Annual Cost to Federal Government: $1,600

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

---

Common Form ICR:  No

---

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: 10/01/2021

---