Outstanding Americans by Choice Nominee Questionnaire and Citizenship Ambassador Nominee Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form G-1580 Citizenship Ambassadors Nominee Questionnaire	Form	New	Available
Form G-1580 Citizenship Ambassador Nominee Questionnaire	Form	New	Repair queued
Form G-1579A Outstanding Americans by Choice Supplemental Questionnaire	Form	New	Available
Form G-1579 Outstanding Americans by Choice Nominee Questionnaire	Form	New	Available
Form G-1579 Outstanding Americans by Choice Nominee Questionnaire	Form	New	Repair queued
G-1579 & G-1580 NEW Supporting Statement.docx	Supporting Statement A	Uploaded 2023-02-21	Available
30-Day FRN.pdf	Supplementary Document	Uploaded 2023-02-21	Repair queued
60-Day FRN.pdf	Supplementary Document	Uploaded 2023-02-21	Repair queued
G-1580 Introduction Script.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
GRATUITOUS-SERVICE-AGREEMENT-FINAL.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 3 to Citizenship Ambassador Candidates (nonselection notice).docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 2 to Citizenship Ambassadors Nominees (Confirmation of Eligibility).docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 1 to Citizenship Ambassadors.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
DHS-USCIS-PIA-016.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
DHS-ALL-PIA-006 DHS General Contact Lists.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
DHS-ALL-PIA-031.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
SORN DHS-USCIS-007 BIS.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
SORN DHS-ALL-002.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
SORN DHS-ALL-011 .pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
SORN-DHS-ALL-024.pdf	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 3 to ABC Candidates.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 2 to ABC Nominees.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Notice 1 to ABC Candidates.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued
Introduction Script.docx	Supplementary Document	Uploaded 2023-02-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
258582	Citizenship Ambassador Nominee Questionnaire	Form	New	Citizenship Ambassadors Nominee Questionnaire
258582	Citizenship Ambassador Nominee Questionnaire	Form	New
258582	Citizenship Ambassador Nominee Questionnaire	Instruction	New
258581	Outstanding Americans by Choice Nominee Questionnaire	Form	New	Outstanding Americans by Choice Supplemental Questionnaire
258581	Outstanding Americans by Choice Nominee Questionnaire	Form	New	Outstanding Americans by Choice Nominee Questionnaire
258581	Outstanding Americans by Choice Nominee Questionnaire	Form	New
258581	Outstanding Americans by Choice Nominee Questionnaire	Instruction	New

ICR Details

OMB Control No: 1615-0158	ICR Reference No: 202302-1615-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: DHS/USCIS	Agency Tracking No:
Title: Outstanding Americans by Choice Nominee Questionnaire and Citizenship Ambassador Nominee Questionnaire
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/28/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/01/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved
Responses	400	0	0
Time Burden (Hours)	200	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The information collected will be used to determine eligibility for recognition as an Outstanding American by Choice or a Citizenship Ambassador.

---

Authorizing Statute(s): US Code: 8 USC 1443(h) Name of Law: Section 332(h) of the Immigration and Nationality Act (INA)
  

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:
	87 FR 57711	09/21/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 77855	12/20/2022
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Citizenship Ambassador Nominee Questionnaire	G-1580	Citizenship Ambassadors Nominee Questionnaire
Outstanding Americans by Choice Nominee Questionnaire	G-1579, G-1579A	Outstanding Americans by Choice Nominee Questionnaire ,   Outstanding Americans by Choice Supplemental Questionnaire

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	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	400	0	0	400	0	0
Annual Time Burden (Hours)	200	0	0	200	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

---

Annual Cost to Federal Government: $9,220

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: 03/01/2023

---