83c

G-1041A-010 83C 20240814.pdf

Genealogy Index Search Request and Genealogy Records Request

83C

OMB: 1615-0096

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PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS-USCIS

0096
1615
___ ___
___ ___ - ___
___ ___ ___
Enter only items that change
Current record

New record

Agency form number (s)

G-1041/A

Annual reporting and recordkeeping hour
burden
Number of respondents

6,767

14,660

Total annual responses

6,767

14,660

Percent of these responses
collected electronically
Total annual hours

0

%

2,145

98.0

%

4,403

Difference

2,258

Explanation of difference

Addition of efile

Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs

0

0

Total annual costs (O&M)

0

0

Total annualized cost requested

25,376

1,080

Difference

-24,296

Explanation of difference

efiling eliminates out-of-pocket cost

Program change
Adjustment
Other changes**

USCIS added efiling as an option for the G-1041 and G-1041A. With this change, the estimated timeburden decrease for
efiling. The total estimated number of respondents for paper and efiling combined increased.
Signature of Senior Official or designee:

Date:

8/20/24
** This form cannot be used to extend an expiration date.

OMB 83-C

For OIRA Use
___________________________________
___________________________________

10/95



File Typeapplication/pdf
File TitlePaperwork Reduction Act Submission (OMB 83-I)
SubjectPaperwork Reduction Act Submission (OMB 83-I)
AuthorOMB
File Modified2024-08-20
File Created1999-03-02

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