Request for Fee Waiver

OMB Control No: 1615-0116	ICR Reference No: 201506-1615-006
Status: Historical Active	Previous ICR Reference No: 201505-1615-003
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-912
Title: Request for Fee Waiver
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/25/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/11/2015
Terms of Clearance: Approved for two years only due to lack of GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved	04/30/2016
Responses	505,000	0	402,210
Time Burden (Hours)	590,850	0	470,586
Cost Burden (Dollars)	1,893,750	0	0

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Abstract: The collection of information on Form I-912 is necessary in order for U.S. Citizenship and Immigration Services (USCIS) to make a determination that the applicant is unable to pay the application fee for certain immigration benefits.

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Authorizing Statute(s): US Code: 8 USC 1103 Name of Law: United States Code

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 13880	03/17/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 30698	05/29/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title Form No. Form Name Non-form Request for Fee Waiver DACA-related I-765 Fee Exemption Request Request for Fee Waiver I-912 Request for Fee Waiver 8 CFR 103.7(d) Director's exception request

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ICR Summary of Burden

	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	505,000	402,210	0	0	102,790	0
Annual Time Burden (Hours)	590,850	470,586	0	0	120,264	0
Annual Cost Burden (Dollars)	1,893,750	0	0	0	1,893,750	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: USCIS has changed its estimate of the total burden hours associated with this collection. USCIS previously requested approval of 470,586 total burden hours while it is now requesting the approval of 590,849.92 burden hours. This change in burden estimate is caused by revised estimates regarding the total number of respondents that are likely to request fee waivers, exemptions, and exceptions. The estimated total number of respondents has increased from 402,210 to 505,000 respondents. USCIS estimates that approximately 102,790 new respondents will submit these types of requests. This change in estimates has not been prompted by a program change. Rather, it results from improved agency estimates.

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Annual Cost to Federal Government: $23,634,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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? Uncollected

Agency Contact: Melanie Frank 800 375-5283

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Common Form ICR:  No

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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: 06/11/2015

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