Citizenship and Immigration Services Ombudsman Request for Case Assistance Form (DHS Form 7001)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DHS-7001 Case Assistance Form	Form and Instruction	Unchanged	Available
2025-18562.pdf	Supplementary Document	Uploaded 2025-09-26	Missing upstream
2025-03914 (1).pdf	Supplementary Document	Uploaded 2025-09-17	Repair queued
DHS Request for Case Assistance Form 7001.pdf	Supplementary Document	Uploaded 2022-03-28	Available
PIA CISOMB - CAADI 20210217.pdf	Supplementary Document	Uploaded 2022-02-07	Available
2021-23342.pdf	Supplementary Document	Uploaded 2021-12-16	Repair queued
Supporting_Statement_A_1601_0004_ 09292025.docx	Supporting Statement A	Uploaded 2025-09-29	Available
CISOMB Virtual Ombudsman PIA 20100319 - final signed.doc	Supplementary Document	Uploaded 2011-09-19	Repair queued
SORN (Published).pdf	Supplementary Document	Uploaded 2010-07-22	Repair queued
PRA DHS 7001 Citations.doc	Supplementary Document	Uploaded 2007-11-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
44790	CIS Ombudsman Case Assistance Form	Form and Instruction	Unchanged	Case Assistance Form

ICR Details

OMB Control No: 1601-0004	ICR Reference No: 202508-1601-001
Status: Received in OIRA	Previous ICR Reference No: 202109-1601-002
Agency/Subagency: DHS/OS	Agency Tracking No: 7001
Title: Citizenship and Immigration Services Ombudsman Request for Case Assistance Form (DHS Form 7001)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/30/2025

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2025
Responses	18,000	18,000
Time Burden (Hours)	18,000	18,000
Cost Burden (Dollars)	0	0

---

Abstract: This information collection will be used by the Citizenship and Immigration (CIS) Ombudsman to identify problem areas, propose changes, and assist individuals experiencing problems during the processing of an immigration benefit with U.S. Citizenship and Immigration Services (USCIS)

---

Authorizing Statute(s): PL: Pub.L. 107 - 296 452 Name of Law: The Homeland Security Act of 2002
  

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:
	90 FR 12171	03/14/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 46231	09/25/2025
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
CIS Ombudsman Case Assistance Form	DHS-7001	Case Assistance Form

---

ICR Summary of Burden

table that charts list 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	18,000	18,000	0	0	0	0
Annual Time Burden (Hours)	18,000	18,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $1,231,200

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: 09/30/2025

---