OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status

ICR 200908-1615-002 · OMB 1615-0070 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form I-643 Health amd Human Services Statistical Data for Refugee/Asylee Adjusting Status Form and Instruction Modified Available
I-643 Support State 8-20-09.doc Supporting Statement A Uploaded 2009-08-20 Available
Published 30-Day Notice 8-5-09.doc Supplementary Document Uploaded 2009-08-07 Repair queued
Published 60 Day Notice 5-21-09.doc Supplementary Document Uploaded 2009-08-07 Available
INA 413.doc Supplementary Document Uploaded 2007-05-31 Available
Public Law 97-359.pdf Supplementary Document Uploaded 2007-05-31 Available
Section 202 of Pub. Law 99-603.doc Supplementary Document Uploaded 2007-05-31 Available
IC Document Collections
IC IDCollectionTypeStatusForm
20384 Health amd Human Services Statistical Data for Refugee/Asylee Adjusting Status Form and Instruction Modified
ICR Details
1615-0070 200908-1615-002
Historical Active 200805-1615-013
DHS/USCIS
Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status
Extension without change of a currently approved collection   No
Regular
Approved without change 10/29/2009
Retrieve Notice of Action (NOA) 08/21/2009
Approved for only one year due to lack of GPEA compliance.
  Inventory as of this Action Requested Previously Approved
10/31/2010 36 Months From Approved 10/31/2009
195,000 0 195,000
178,620 0 178,620
0 0 0
Certain refugees and asylees, must use this form when applying for adjustment of status with USCIS. USCIS will submit the data collected on this form to HHS. HHS will include this information when submitting it's annual report to Congress under section 413(a) of the Immigration and Nationality Act.
PL: Pub.L. 99 - 603 202 Name of Law: Cuban/Haitian Entrants
   US Code: 8 USC 1522 Name of Law: U.S. Code
  
None
Not associated with rulemaking
  74 FR 23875 05/21/2009
74 FR 39088 08/05/2009
No
  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 195,000 195,000 0 0 0 0
Annual Time Burden (Hours) 178,620 178,620 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$3,935,100
No
No
Uncollected
Uncollected
No
Uncollected
Evadne Hagigal 202 272-0993 [email protected]
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/21/2009