Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

Forms and Documents

Document Name	Status
Form I-102 I-102 Electronic Filing Form and Instruction	Unchanged
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document Form	Modified
I-102 Supporting Statement.doc Supporting Statement A	2016-10-25
83c I-102.pdf Justification for No Material/Nonsubstantive Change	2016-10-24
I102-INS-TOC-ELISI94-30Day-09162014.docx Supplementary Document	2014-10-09
USCIS 015 ELIS 2 Account and Case Management SORN.pdf Supplementary Document	2014-02-03
privacy_pia_uscis_elis_2_accountmgmt.pdf Supplementary Document	2014-02-03
Reference Citation.doc Supplementary Document	2013-04-04
SORN - United States Citizenship and Immigration Services Benefits Information System.doc Supplementary Document	2012-06-12
PIA - USCIS Benefits Processing of Applicants other than.pdf Supplementary Document	2012-06-12

IC Document Collections

IC ID	Document Title	Status
210247	I-102 Electronic Filing Form and Instruction	Unchanged
20403	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document Form	Modified

ICR Details

OMB Control No: 1615-0079	ICR Reference No: 201610-1615-041
Status: Historical Active	Previous ICR Reference No: 201402-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-102
Title: Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/31/2016
	Date Received in OIRA: 10/26/2016
Terms of Clearance: USCIS may continue to use the previous version of the instrument until December 23, 2016.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	10/31/2017	10/31/2017
Responses	6,782	0	6,782
Time Burden (Hours)	4,611	0	4,611
Cost Burden (Dollars)	1,860,981	0	1,860,981

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Abstract: An alien temporarily residing in the United States can use this form to request a replacement of his or her lost, stolen, mutilated arrival-departure document, or he or she may also request a new arrival-departure record, if one was not issued when he or she was last admitted as a nonimmigrant, and has not since been issued such record but is in need of one USCIS uses the information provided by the requester to verify eligibility, as well as his or her status, process the request and issue a new or replacement arrival-departure record.

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Authorizing Statute(s): US Code: 8 USC 1304 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:
	78 FR 56240	09/12/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 77139	12/20/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
I-102 Electronic Filing	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

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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	6,782	6,782	0	0	0	0
Annual Time Burden (Hours)	4,611	4,611	0	0	0	0
Annual Cost Burden (Dollars)	1,860,981	1,860,981	0	0	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: There has been an increase in the estimated annual burden hours previously reported. The increase is due to the agency's newest estimate regarding the time burden associated with this collection. USCIS previously reported 2,821.31 burden hours but it is now seeking approval of 3,156.22 burden hours. USCIS has made some revisions to the form and instructions. Additional data collection fields are being incorporated into the form to enable verification of status in the United States based upon passport or travel document information captured by CBP at the port of entry, which also may be used to search TECS and ADIS. This additional information is deemed necessary to ensure timely verification in cases where the individual does not have his or her Form I-94 admission information, particularly as a result of CBP's automation of the Form I-94 process. In addition, the Applicant's and Preparer's sections have been revised, and an Interpreter's section has been added to the form and instructions. USCIS now estimates that it takes an applicant 30 minutes to prepare and submit this request using a paper form. Finally, the ELIS Account Number data collection has been added to the form. The changes being proposed will be made to the most recent edition of the form approved by OMB, dated 2/17/13 N, which was approved by OMB upon USCIS request to approve changes to this collection based on DHS's Interim Final Rule, Definition of Form I-94 to Include Electronic Format, at 78 FR 18457, March 27, 2013. USCIS initially estimates that filing this request electronically will take 25 minutes.

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Annual Cost to Federal Government: $2,238,959

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: 10/26/2016

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