Approved
consistent with changes described in INS memos of 1-20-99, 1-25-99
and 2-5-99. and revised form to incorporate previous terms of
clearance. By the time of this collection's next submission, the
words (if applicable) will be added after the social security
number. Also, INS will meet with OMB within the next five months to
discuss the electronic submission of this and other forms.
Inventory as of this Action
Requested
Previously Approved
07/31/1999
07/31/1999
04/30/2000
20,000
0
300,000
40,000
0
900,000
1,600,000
0
33,000,000
These medical certifications will be
used to support an applicant claim to an exception of the literacy
and history/government knowledge requirements found in section 312
of the Immigration and Nationality Act. The INS Adjustment Officers
are not medical doctors and should not be placed in the position of
making medical determinations. These certifications, which are
executed by licensed health care providers, are needed to support
the applicant's claim of an exception to this naturalization
requirement.
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.
Medical Certification for Disability Exceptions