Affidavit of Relationship

Forms and Documents

Document Name	Status
Form DS-7656 Affidavit of Relationship Form and Instruction	New
Worldwide Refugee Admissions Processing System (WRAPS) PIA (7-2012).docx Supplementary Document	2012-07-03
SORN for AoR State-59 (7-2012).pdf Supplementary Document	2012-07-03
OMB request on DNA (7-2012).DOCX Supplementary Document	2012-07-03
Legal Authorities (2-2012).docx Supplementary Document	2012-02-16
Revised Supporting Statement (7-3-12).docx Supporting Statement A	2012-07-03

IC Document Collections

IC ID	Document Title	Status
200164	Affidavit of Relationship Form and Instruction	New

ICR Details

OMB Control No: 1405-0206	ICR Reference No: 201111-1405-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Affidavit of Relationship
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/20/2012
	Date Received in OIRA: 02/16/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	36 Months From Approved
Responses	3,500	0	0
Time Burden (Hours)	3,500	0	0
Cost Burden (Dollars)	525,000	0	0

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Abstract: The Affidavit of Relationship (AOR) will be required by the Department of State to establish qualifications for access to the Priority 3 Family Reunification category of the United States Refugee Admissions Program (USRAP) by persons of certain nationalities who are family members of qualifying persons already admitted to the U.S. as refugees or who were granted asylum in the U.S., including persons who may now be lawful residents or U.S. citizens.

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Authorizing Statute(s): EO: EO 13313 Name/Subject of EO: Delegation of Certain Congressional Reporting Functions
   US Code: 8 USC 1157 Name of Law: Immigration Nationality Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 54690	09/08/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 70804	11/15/2011
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Affidavit of Relationship	DS-7656, DS 7656	Affidavit of Relationship ,   Affidavit of Relationship

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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	3,500	0	0	3,500	0	0
Annual Time Burden (Hours)	3,500	0	0	3,500	0	0
Annual Cost Burden (Dollars)	525,000	0	0	525,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Burden change due to this submission as a new collection

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Annual Cost to Federal Government: $1,678,333

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]? 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? Uncollected

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Common Form ICR:  No

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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: 02/16/2012

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