83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

Department of Homeland Security, U.S. Citizenship and Immigration Services
Enter only items that change
Current record

0123
1615
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___ ___ - ___
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New record

Agency form number (s)

I-601A, Application for Provisional
Unlawful Presence Waiver
Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%

Total annual hours
Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

USCIS requests a modification to the 601A instructions to clarify when USCIS will retain or destroy original paper records
submitted to the agency. The language in the instructions is to remind the public that they should not submit original
documents to USCIS unless specifically requested to do so.
Signature of Senior Official or designee:

Date:

12/8/2023
** This form cannot be used to extend an expiration date.

OMB 83-C

For OIRA Use
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10/95