Medical Certification for Disability Exceptions

Forms and Documents

Document Name	Status
Form Form N-648 Medical Certification for Disability Exceptions Form	Modified
Supporting Statement 1615-0060 N-648 10-23-14.doc Supporting Statement A	2014-10-23
A File SORN 76 FR 343233 (June 13, 2011).htm Supplementary Document	2014-10-23
BIS SORN 73 FR 56596 (September 29, 2008).htm Supplementary Document	2014-10-23
N-648 30-day notice 8-6-214.pdf Supplementary Document	2014-10-23
Privacy CLAIMS4.pdf Supplementary Document	2014-10-23
N-648 60-Day Notice 5-12-14.pdf Supplementary Document	2014-10-23
Reference citation 8-8-12.doc Supplementary Document	2012-08-08

IC Document Collections

IC ID	Document Title	Status
20362	Medical Certification for Disability Exceptions Form	Modified

ICR Details

OMB Control No: 1615-0060	ICR Reference No: 201410-1615-003
Status: Historical Active	Previous ICR Reference No: 201208-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No: N-648
Title: Medical Certification for Disability Exceptions
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: 03/11/2015
	Date Received in OIRA: 12/23/2014
Terms of Clearance: Approved for two years due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved	03/31/2015
Responses	17,302	0	13,801
Time Burden (Hours)	34,604	0	27,602
Cost Burden (Dollars)	847,798	0	0

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Abstract: USCIS uses the Form N-648 to substantiate a claim for an exception to the requirements of section 312(a) of the Immigration and Nationality Act. By certifying Form N-648, the doctor states that an applicant filing an Application for Naturalization, Form N-400, is unable to complete the English and/or civics requirements because of a physical or developmental disability or mental impairment(s).

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Authorizing Statute(s): US Code: 8 USC 1423 Name of Law: U.S. Code
  

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:
	79 FR 26979	05/12/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 45830	08/06/2014
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
Medical Certification for Disability Exceptions	Form N-648	Medical Certification for Disability Exceptions

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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	17,302	13,801	0	0	3,501	0
Annual Time Burden (Hours)	34,604	27,602	0	0	7,002	0
Annual Cost Burden (Dollars)	847,798	0	0	0	847,798	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: There has been an increase of 7,002 burden hours previously reported for this information collection. This adjustment in agency estimates can be attributed to the increase in the estimated annual number of respondents from 13,801 to 17,302, based on updated statistical data using the average of FY2011 to 2013 annual receipts. There is no change in the information being collected. There is an increase of 847,798 in the estimated total annual cost burden associated with this information collection. This increase is the result of accounting for the out-of-pocket costs that respondents may incur as described under item 13 of the supporting statement.

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Annual Cost to Federal Government: $5,818,576

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: 12/23/2014

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