Information Collection Request

Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

ICR 201911-1615-027 · OMB 1615-0079 · Historical Inactive

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1615-0079 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified	Available
I-102-Supporting Statement-Fee Rule-83C-NPRM.docx	Supporting Statement A	Uploaded 2019-11-14	Available
I-102 83C.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2019-11-12	Repair queued
I102-FRM-TOC-30Day-REV-08152019.docx	Supplementary Document	Uploaded 2019-09-09	Repair queued
SORN 018 DHS_USCIS IBBC 20180731.pdf	Supplementary Document	Uploaded 2019-09-09	Repair queued
I102-INS-TOC-2019FeeRule-10302019.docx	Supplementary Document	Uploaded 2019-11-12	Repair queued
privacy-pia-016a-uscis-claims3-march25,2016.pdf	Supplementary Document	Uploaded 2017-08-11	Repair queued
privacy-pia-003b-uscis-iddmp-feb28,2017.pdf	Supplementary Document	Uploaded 2017-08-11	Available
Reference Citation.docx	Supplementary Document	Uploaded 2017-08-21	Repair queued
SORN 001 AFileIndexNFTS 2013 11 21.html	Supplementary Document	Uploaded 2017-08-11	Repair queued
SORN 007 Benefits Info Sys 2016 10 19.pdf	Supplementary Document	Uploaded 2017-08-11	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
20403	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form	Modified

ICR Details

OMB Control No: 1615-0079	ICR Reference No: 201911-1615-027
Status: Historical Inactive	Previous ICR Reference No: 201909-1615-002
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-102
Title: Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/21/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/27/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	4,100	0	4,100
Time Burden (Hours)	3,075	0	3,075
Cost Burden (Dollars)	1,182,440	0	1,182,440

Abstract: An alien temporarily residing in the United States can use this form to request a replacement of his or her lost, stolen, mutilated arrival-departure document, or he or she may also request a new arrival-departure record, if one was not issued when he or she was last admitted as a nonimmigrant, and has not since been issued such record but is in need of one USCIS uses the information provided by the requester to verify eligibility, as well as his or her status, process the request and issue a new or replacement arrival-departure record.

Authorizing Statute(s): US Code: 8 USC 1304 Name of Law: U.S. Code

Citations for New Statutory Requirements: None

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

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 26422	06/06/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 46961	09/06/2019
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

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:

Annual Cost to Federal Government: $1,824,500

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

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 202 527-4488 [email protected]

Common Form ICR: No