Approved; INS
request to not display the expiration date on the form is approved.
Upon reprinting the form, INS shall add the required PRA burden
statement and disclosure statement to the form. This approval is
contingent upon INS providing additional information on the utility
of the employment and immediate family information which is
currently required. If INS determines the information is no longer
required, they may submit an Information Correction Worksheet with
the revised form.
Inventory as of this Action
Requested
Previously Approved
02/29/2000
02/29/2000
02/28/1997
300
0
300
75
0
75
27,000
0
0
Information collected on this form
will be used by the Service to determine whether an applicant is
eligible for discretionary relief under section 212(c) of the
Act.
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.