Application for Advance Permission to Return to Unrelinquished Domicile

Forms and Documents

Document Name	Status
Form I-191 Application for Advance Permission to Return to Unrelinquished Domicile Form and Instruction	Modified
References.doc Supplementary Document	2007-02-16
30-Day Published 2-15-07.doc Supplementary Document	2007-02-16
60-Day Published 11-30-06.doc Supplementary Document	2007-02-16
I-191 Supp Statement 2-7-07.doc Supporting Statement A	0000-00-00

IC Document Collections

IC ID	Document Title	Status
20264	Application for Advance Permission to Return to Unrelinquished Domicile Form and Instruction	Modified

ICR Details

OMB Control No: 1615-0016	ICR Reference No: 200702-1615-005
Status: Historical Active	Previous ICR Reference No: 200310-1615-004
Agency/Subagency: DHS/USCIS	Agency Tracking No:
Title: Application for Advance Permission to Return to Unrelinquished Domicile
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/13/2007
	Date Received in OIRA: 04/04/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2010	36 Months From Approved	06/30/2007
Responses	300	0	300
Time Burden (Hours)	75	0	75
Cost Burden (Dollars)	80,250	0	59,000

---

Abstract: The information collected on this form is used by U.S. Citizenship and Immigration Services (USCIS) to determine whether the applicant is eligible for a discretionary relief under section 212(c) of the Immigration and Nationality Act (Act).

---

Authorizing Statute(s): US Code: 8 USC 1182 Name of Law: Immigration and Nationality 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:
	71 FR 69214	11/30/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 7449	02/15/2007
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Application for Advance Permission to Return to Unrelinquished Domicile	I-191	Application for advance permission to return to unrelinquished Domicile

---

ICR Summary of Burden

	Total Approved	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	300	300	0	0	0	0
Annual Time Burden (Hours)	75	75	0	0	0	0
Annual Cost Burden (Dollars)	80,250	59,000	0	21,250	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: $0

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

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: 04/04/2007

---