Information Collection Request

Case Assistance Form (Ombudsman Form DHS-7001) and Instructions (Form DHS-7001)

ICR 201807-1601-001 · OMB 1601-0004 · Active

Forms and Documents
DocumentTypeStatusAvailability
30 day FRN 1601-0004 7-17-18.pdf Supplementary Document Uploaded 2018-07-31 Repair queued
60 day FRN 1601-0004 4-24-18.pdf Supplementary Document Uploaded 2018-07-31 Available
PTA CISOMB - Form 7001 - Ombudsman Case Assistance Online System 20150309 PRIV FINAL.pdf Supplementary Document Uploaded 2015-07-22 Repair queued
Supporting_Statement_A_1601_0004_ 07-31-18.docx Supporting Statement A Uploaded 2018-07-31 Repair queued
1601-0004_30 Day FRN Published.pdf Supplementary Document Uploaded 2015-06-02 Available
CISOMB Virtual Ombudsman PIA 20100319 - final signed.doc Supplementary Document Uploaded 2011-09-19 Repair queued
1601-0004_60 day FRN Published.pdf Supplementary Document Uploaded 2015-06-02 Repair queued
SORN (Published).pdf Supplementary Document Uploaded 2010-07-22 Repair queued
PRA DHS 7001 Citations.doc Supplementary Document Uploaded 2007-11-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
44790 CIS Ombudsman Case Assistance Form Instruction Modified
ICR Details
1601-0004 201807-1601-001
Active 201410-1601-001
DHS/OS
Case Assistance Form (Ombudsman Form DHS-7001) and Instructions (Form DHS-7001)
Extension without change of a currently approved collection   No
Regular
Approved without change 02/13/2019
Retrieve Notice of Action (NOA) 07/31/2018
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved 02/28/2019
12,000 0 8,800
12,000 0 8,800
0 0 0

This information collection will be used by the Citizenship and Immigration (CIS) Ombudsman to identify problem areas, propose changes, and assist individuals experiencing problems during the processing of an immigration benefit with U.S. Citizenship and Immigration Services (USCIS)

PL: Pub.L. 107 - 296 452 Name of Law: The Homeland Security Act of 2002
  
None

Not associated with rulemaking

  83 FR 17833 04/24/2018
83 FR 33244 07/17/2018
No

1
IC Title Form No. Form Name
CIS Ombudsman Case Assistance Form DHS Form 7001 , DHS Form 7001 Citizenship and Immigration Services Ombudsman ,   Citizenship and Immigration Services Ombudsman

  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 12,000 8,800 0 0 3,200 0
Annual Time Burden (Hours) 12,000 8,800 0 0 3,200 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There has been an increase of 3,200 in the estimated annual burden hours previously reported for this information collection. The increase in burden hours is a reflection of agency estimates. There is no change in the information being collected, however there have been cosmetic changes to the form including punctuation, formatting, and text changes to make the form more understandable and streamlined for use by respondents

$547,200
No
    Yes
    Yes
No
No
No
Uncollected
Raymond Mills 202 357-8100

  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.
07/31/2018