Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

Forms and Documents

Document Name	Status
Form I-102 I-102 Electronic Filing Form and Instruction	Removed
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document Form	Modified
I102-INS-TOC-30 Day-07242017.docx Supplementary Document	2017-08-11
I-102 30day FRN 20170808.pdf Supplementary Document	2017-08-11
I-102 60d FRN 20170314.pdf Supplementary Document	2017-08-11
privacy-pia-016a-uscis-claims3-march25,2016.pdf Supplementary Document	2017-08-11
privacy-pia-003b-uscis-iddmp-feb28,2017.pdf Supplementary Document	2017-08-11
Reference Citation.docx Supplementary Document	2017-08-21
SORN 001 AFileIndexNFTS 2013 11 21.html Supplementary Document	2017-08-11
SORN 007 Benefits Info Sys 2016 10 19.pdf Supplementary Document	2017-08-11
PTA USCIS - Form I-102 20170517 PRIV Final.pdf Supplementary Document	2017-08-11
1615-0079 SS A I-102 (30d) Final.docx Supporting Statement A	2017-09-11

IC Document Collections

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

ICR Details

OMB Control No: 1615-0079	ICR Reference No: 201708-1615-002
Status: Historical Active	Previous ICR Reference No: 201610-1615-041
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-102
Title: Application for Replacement/Initial Nonimmigrant Arrival-Departure Document
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: 10/19/2017
	Date Received in OIRA: 09/13/2017
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2019	36 Months From Approved	10/31/2017
Responses	6,899	0	6,782
Time Burden (Hours)	5,174	0	4,611
Cost Burden (Dollars)	1,892,870	0	1,860,981

---

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.

---

Authorizing Statute(s): US Code: 8 USC 1304 Name of Law: U.S. Code
  

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:
	82 FR 13651	03/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 37107	08/08/2017
Did the Agency receive public comments on this ICR? Yes

---

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

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

---

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	6,899	6,782	0	0	117	0
Annual Time Burden (Hours)	5,174	4,611	0	0	563	0
Annual Cost Burden (Dollars)	1,892,870	1,860,981	0	0	31,889	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: USCIS is removing the respondents and burden previously reported for I-102 Electronic Filing from this ICR, as the electronic filing capability is not yet available. USCIS is also reporting a slight increase in the total number of respondents for this ICR. The increase in the number of respondents resulted in corresponding increases in the total hour and cost burdens.

---

Annual Cost to Federal Government: $3,070,055

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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

---

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: 09/13/2017

---