Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form

Forms and Documents

Document Name	Status
Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form Form and Instruction	New
Justification for Emergency Review - OMB - Border Crossing Survey_signed.docx Supplementary Document	2023-09-12
LegalAuthorities - OMB - Border Crossing Survey.docx Supplementary Document	2023-09-11
Supporting-Statement - Border Crossing 8.31.docx Supporting Statement A	2023-09-11

IC Document Collections

IC ID	Document Title	Status
262118	Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202309-1405-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/18/2023
Date Submitted to OIRA: 09/12/2023

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	3,293	0
Time Burden (Hours)	1,098	0
Cost Burden (Dollars)	0	0

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Abstract: This collection is related to the Memorandum of Understanding (MOU) between the United States and the Government of Israel (GOI) on the Extension of Reciprocal Privileges and the Visa Waiver Program, and is for the purposes of monitoring the GOI’s implementation of its commitments in the MOU to treat all U.S. citizens seeking to enter Israel without regard to national origin, religion or ethnicity.

Emergency Justfication: On July 18, the Government of Israel notified the U.S. government that it planned to announce new travel requirements on July 19, and that they would go into effect on July 20. As there was only two days' notice, the Department was unable to engage in a public comment period to solicit input on the survey.

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Authorizing Statute(s): US Code: 8 USC 1101 Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1104 Name of Law: Powers and Duties of Secretary of State
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form	NA	U.S. Embassy Jerusalem Incident Reporting Form

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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	3,293	0	0	3,293	0	0
Annual Time Burden (Hours)	1,098	0	0	1,098	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: See supporting statement.

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Annual Cost to Federal Government: $8,245

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.     No

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.     No

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

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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: 09/12/2023

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