Special Immigrant Visa Biodata Form

OMB Control No: 1405-0203	ICR Reference No: 202101-1405-004
Status: Received in OIRA	Previous ICR Reference No: 201903-1405-004
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Special Immigrant Visa Biodata Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/22/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	14,000	14,000
Time Burden (Hours)	3,500	3,500
Cost Burden (Dollars)	0	0

---

Abstract: The information in this collection will aid DOS/PRM partners to arrange travel, select a resettlement site and prepare for services needed by Iraqi or Afghan citizens who worked with the U.S. Government or contractor, obtained a Special Immigrant Visa (SIV) because of this employment, and elected refugee resettlement benefits.

---

Authorizing Statute(s): PL: Pub.L. 110 - 181 1244(g) Name of Law: The Refugee Crisis in Iraq Act    PL: Pub.L. 109 - 163 1059 Name of Law: National Defense Authorization Act    PL: Pub.L. 110 - 161 525 Name of Law: Consolidated Appropriations Act

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:
	85 FR 70702	11/05/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 5305	01/19/2021
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 Special Immigrant Visa Biodata Form DS-0234 Special Immigrant Visa Biodata Form

---

ICR Summary of Burden

	Total Request	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	14,000	14,000	0	0	0	0
Annual Time Burden (Hours)	3,500	3,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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:

---

Annual Cost to Federal Government: $171,605

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.     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? No

Agency Contact: Irving Jones 202 453-9248

---

Common Form ICR:  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:
		(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: 01/22/2021

---