OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Authorization to Issue Certification for Health Care Workers and Related Requirements

ICR 201107-1615-003 · OMB 1615-0086 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
I-905 Supp Statement 10-20-11.DOC Supporting Statement A Uploaded 2011-10-20 Available
Published 30day Notice 07.08.11.doc Supplementary Document Uploaded 2011-07-14 Available
Published 60-Day Notice 4-12-11.doc Supplementary Document Uploaded 2011-07-14 Available
SORN - United States Citizenship and Immigration Services Benefits Information System.doc Supplementary Document Uploaded 2011-07-12 Repair queued
PIA - USCIS Benefits Processing of Applicants other than.pdf Supplementary Document Uploaded 2011-07-12 Available
Approved PTA.pdf Supplementary Document Uploaded 2011-07-12 Available
Reference cite.doc Supplementary Document Uploaded 2009-04-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
20415 Application for Authorization to Issue Certification for Health Care Workers and Related Requirements Instruction Modified
ICR Details
1615-0086 201107-1615-003
Historical Active 200904-1615-002
DHS/USCIS
Application for Authorization to Issue Certification for Health Care Workers and Related Requirements
Extension without change of a currently approved collection   No
Regular
Approved with change 10/30/2011
Retrieve Notice of Action (NOA) 07/19/2011
Approved for only one year due to lack of GPEA compliance.
  Inventory as of this Action Requested Previously Approved
10/31/2012 36 Months From Approved 10/31/2011
28,010 0 28,010
51,280 0 51,280
4,552,300 0 4,552,000
This form is necessary for an organization to request authorization from the USCIS to issue certificates to foreign health care workers. The data collected on this form is used by the USCIS to determine eligibility to issue certificates.
US Code: 8 USC 1182 Name of Law: U.S. Code
  
None
Not associated with rulemaking
  76 FR 20362 04/12/2011
76 FR 40386 07/08/2011
Yes
  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 28,010 28,010 0 0 0 0
Annual Time Burden (Hours) 51,280 51,280 0 0 0 0
Annual Cost Burden (Dollars) 4,552,300 4,552,000 0 300 0 0
No
No
$0
No
No
No
No
No
Uncollected
Liana Miranda-Valido 202 272-8887 [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.
07/19/2011