Information Collection

E-Verify Self Check - Self Check Query

IC 210424 under ICR 201609-1615-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
E-Verify Self Check - Self Check Query Form and Instruction
Self Check Content Document 1a. PRA_SelfCheck Content Document for PRA.docx Form and Instruction
Self-Check Wireframes 1b. Self Check Wireframes_for PRA.PDF Form and Instruction
Self Check Content Document_ScreenShots 7-22-14.docx E-Verify Self-Check Screenshots (Comprehensive) IC Document

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	n/a	Self Check Content Document	1a. PRA_SelfCheck Content Document for PRA.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Self-Check Wireframes	1b. Self Check Wireframes_for PRA.PDF		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: DHS/USCIS-013 E-Verify Self-Check	FR Citation: 76 FR 9034

Number of Respondents: 75,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	75,000	-2,100,000	2,175,000
Annual IC Time Burden (Hours)	6,248	-174,930	181,178
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
E-Verify Self-Check Screenshots (Comprehensive)	Self Check Content Document_ScreenShots 7-22-14.docx	07/24/2014

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