Application for Employment Authorization

Forms and Documents

Document Name	Status
Form I-765WS Work Sheet Form	Modified
Form I-765 Application for Employment Authorization Form	Modified
FRM I765 SSA 83C signed_15FEB2017.pdf Justification for No Material/Nonsubstantive Change	2017-02-15
SSA SORN 60-058 79FR8780_13FEB2014.pdf Supplementary Document	2017-02-15
SSA SORN 60-058 78FR40542_5JUL2013.pdf Supplementary Document	2017-02-15
SSA SORN 60-058 75FR82121_29DEC2010.pdf Supplementary Document	2017-02-15
USCIS-010 Asylum Information and Pre-Screening SORN.pdf Supplementary Document	2016-11-21
Reference citations_FRM I7654 SSA 73C_14FEB2017.doc Supplementary Document	2017-02-15
privacy_pia_cis_claims3.pdf Supplementary Document	2016-11-21
DHS-USCIS-PIA-027 RAPS.pdf Supplementary Document	2016-11-21
DHS-USCIS-007 BIS.pdf Supplementary Document	2016-11-21
DHS-USCIS-001 Alien File, Index.pdf Supplementary Document	2016-11-21
FRM I765 SSA 83C Supporting StatementVer2_14FEB2017.docx Supporting Statement A	2017-02-15
I765-INS-TOC-WIP-SS-01192017.docx Supplementary Document	2017-02-15
I765-FRM-TOC-WIP-SS-01192017.docx Supplementary Document	2017-02-15

IC Document Collections

IC ID	Document Title	Status
225726	SSA Enumeration	New
203680	Passport-Style Photographs	Unchanged
203678	Work Sheet Form	Modified
203677	Biometric Processing	Modified
20321	Application for Employment Authorization Form	Modified

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201702-1615-005
Status: Historical Active	Previous ICR Reference No: 201701-1615-002
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-765, I-765WS
Title: Application for Employment Authorization
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 without change	Conclusion Date: 04/13/2017
	Date Received in OIRA: 02/17/2017
Terms of Clearance: USCIS may continue to use the previously approved instruments through July 16, 2017.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2018	02/28/2018	02/28/2018
Responses	5,334,113	0	4,934,113
Time Burden (Hours)	9,019,179	0	8,985,859
Cost Burden (Dollars)	650,414,992	0	650,414,992

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Abstract: USCIS will use the information collected to determine eligibility for work authorization and for the issuance of an employment authorization document.

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Authorizing Statute(s): US Code: 8 USC 1153 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:
1615-AC04	Final or interim final rulemaking	82 FR 5238	01/17/2017

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Application for Employment Authorization	I-765	Application for Employment Authorization Document
Biometric Processing
Work Sheet	I-765WS	I-765 Work Sheet
Passport-Style Photographs
SSA Enumeration

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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	5,334,113	4,934,113	0	400,000	0	0
Annual Time Burden (Hours)	9,019,179	8,985,859	0	33,320	0	0
Annual Cost Burden (Dollars)	650,414,992	650,414,992	0	0	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: USCIS will transfer burden from SSA’s OMB 0960-0066 (Form SS-5) for the 400,000 qualified respondents seeking SSA enumeration with Form I-765. The estimated 400,000 respondents seeking SSA enumeration are estimated to spend an additional 5 minutes reading the instructions and responding to the six SSA enumeration questions on the form, which is a 33,320-hour increase in annual burden hours to this collection.

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Annual Cost to Federal Government: $911,635,125

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: 02/17/2017

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