Approved
consistent with the following terms: 1. With the next submission,
INS will consolidate this form with the five forms with which it is
used or explain why this is not feasible. 2. Within six months, INS
will meet with OMB to discuss the eventual electronic submission of
this and other INS forms. 3. INS shall immediately ensure that this
form is in full compliance with the Privacy Act including any
necessary disclosures under the Act.
Inventory as of this Action
Requested
Previously Approved
01/31/2002
01/31/2002
12/31/1998
1,144,994
0
1,144,994
286,249
0
286,249
0
0
0
This form is used when it is necessary
to check other agency records (FBI, CIA, etc.) on applications or
petitions submitted by applicants for benefits under the I&NA.
Additionally, the form is required from applicants for adjustment
to permanent resident status and specific applicants for
naturalization.
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.