Information Collection

E-Verify Self Check Program

IC 195662 under ICR 201012-1615-003 · OMB 1615-0117.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0117 can be found here:

Documents and Forms

Document Name Document Type
Screen Shots Self Check 12-8-10.pdf Other-Screen Shots
E-Verify Self Check Website Content - 12-21-10.doc Other-Screen Shot in Word Document 1

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	E-Verify Self Check Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shots			Screen Shots Self Check 12-8-10.pdf		Yes	Yes	Fillable Fileable
Other-Screen Shot in Word Document 12-21-10			E-Verify Self Check Website Content - 12-21-10.doc		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,080,582	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,080,582	5,080,582
Annual IC Time Burden (Hours)	429,352	429,352
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.