Information Collection

Application for Deferred Action for Childhood Arrivals (Initial Requests)

IC 203576 under ICR 202109-1615-004 · OMB 1615-0124.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0124 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I-821D Application for Deferred Action for Childhood Arrivals (Initial Requests)	Form
I821D-012-INS-DACARule-09272021.pdf www.uscis.gov/i-821d	Instruction
I821D-012-INS-DACARule-09272021.pdf www.uscis.gov/i-821d	Instruction
I-821D Application for Deferred Action for Childhood Arrivals I821D-012-FRM-DACARule-09272021.pdf www.uscis.gov/i-821d	Form
I-821D Application for Deferred Action for Childhood Arrivals I821D-012-FRM-DACARule-09272021.pdf www.uscis.gov/i-821d	Form

IC Title:

Application for Deferred Action for Childhood Arrivals (Initial Requests)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	I-821D	Application for Deferred Action for Childhood Arrivals	I821D-012-FRM-DACARule-09272021.pdf	https://www.uscis.gov/i-821d	Yes	No	Fillable Printable
Instruction			I821D-012-INS-DACARule-09272021.pdf	https://www.uscis.gov/i-821d	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: USCIS Benefits Information System

FR Citation: 73 FR 56596

Number of Respondents: 112,254

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	112,254	71,435	40,819
Annual IC Time Burden (Hours)	336,762	214,305	122,457
Annual IC Cost Burden (Dollars)	12,347,940	7,857,850	4,490,090

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.