Application for Employment Authorization

Forms and Documents

Document Name	Status
Form I-765WS Work Sheet Form	Unchanged
Form I-765 Application for Employment Authorization Form	Modified
Supporting Statement I-765 2017-12-7 IER final v1.docx Supporting Statement A	2017-12-08
I-765 83C final.pdf Justification for No Material/Nonsubstantive Change	2017-12-08
DHS USCIS-010 Asylum Information and Pre-Screening.pdf Supplementary Document	2017-07-10
privacy_pia_cis_rapsapss.pdf Supplementary Document	2017-07-10
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
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

IC Document Collections

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

ICR Details

OMB Control No: 1615-0040	ICR Reference No: 201712-1615-005
Status: Historical Active	Previous ICR Reference No: 201705-1615-008
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: 12/08/2017
	Date Received in OIRA: 12/08/2017
Terms of Clearance: This information collection approval is effective as of December 1, 2017.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2018	02/28/2018	02/28/2018
Responses	4,939,993	0	4,934,113
Time Burden (Hours)	8,997,383	0	8,985,859
Cost Burden (Dollars)	651,308,752	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 99999	07/10/2017

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 99999	07/10/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 99999	07/10/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

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

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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	4,939,993	4,934,113	0	5,880	0	0
Annual Time Burden (Hours)	8,997,383	8,985,859	0	11,524	0	0
Annual Cost Burden (Dollars)	651,308,752	650,414,992	0	893,760	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 is advancing the release date for Form I-765 to December 1, 2017.

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

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

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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: 12/08/2017

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