Application for Employment Authorization for Abused Nonimmigrant Spouse

Forms and Documents

Document Name	Status
I-765V-SS-WIP-Final-20180613.docx Supporting Statement A	2019-01-30
privacy-pia-016a-uscis-claims3-march25,2016.pdf Supplementary Document	2018-05-16
SORN 007 Benefits Info Sys 2016 10 19.pdf Supplementary Document	2018-05-16
SORN 001 AFileIndexNFTS 2013 11 21.html Supplementary Document	2018-05-16
I765V-INS-REV-TOC-30Day-11142017.docx Supplementary Document	2018-05-16
I765V-FRM-REV-TOC-30Day-11142017.docx Supplementary Document	2018-05-16
I-765V 60day FRN 20180215.pdf Supplementary Document	2018-05-16
I-765V 30-day 20180514.pdf Supplementary Document	2018-05-16
PLAW-109publ162 Violence Against Women and Department of Justice Reauthorization Act of 2005 (VAWA 2005).pdf Supplementary Document	2016-10-19
INA-ACT 106 EMPLOYMENT AUTHORIZATION FOR BATTERED SPOUSES OF CERTAIN NONIMMIGRANTS.pdf Supplementary Document	2016-10-19
103.16 Collection, use and storage of biometric information..pdf Supplementary Document	2016-10-19
8 U.S.C. 1324a.pdf Supplementary Document	2016-10-19
8 CFR Part 274a.pdf Supplementary Document	2016-10-19
8 CFR 103.2.pdf Supplementary Document	2016-10-19

IC Document Collections

IC ID	Document Title	Status
223943	Passport Style Photos	Removed
223942	Biometrics	Modified
223940	Application for Employment Authorization for Abused Nonimmigrant Spouse Instruction	Modified

ICR Details

OMB Control No: 1615-0137	ICR Reference No: 201805-1615-007
Status: Active	Previous ICR Reference No: 201610-1615-010
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-765V
Title: Application for Employment Authorization for Abused Nonimmigrant Spouse
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/23/2020
	Date Received in OIRA: 01/31/2019
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	36 Months From Approved	07/31/2020
Responses	1,000	0	3,000
Time Burden (Hours)	2,460	0	4,500
Cost Burden (Dollars)	125,000	0	265,000

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Abstract: Section 814(c) of the Violence Against Women and Department of Justice Reauthorization Act of 2005 (VAWA 2005) amended the Immigration and Nationality Act (INA) to provide eligibility for employment authorization to certain abused spouses of nonimmigrants admitted under INA section 101(a)(15)(A), (E)(iii), (G), or (H). This provision is codified in INA section 106. U.S. Citizenship and Immigration Services (USCIS) will use Form I-765V, Application for Employment Authorization for Abused Nonimmigrant Spouse, to collect the information that is necessary to determine if the applicant is eligible for an initial EAD or renewal EAD as a qualifying abused nonimmigrant spouse.

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Authorizing Statute(s): US Code: 8 USC 1324a(a)(1)(B) Name of Law: Unlawful Employment of Aliens
   US Code: 8 USC 1103 Name of Law: Powers and duties of the Secretary, the Under Secretary, and the Attorney General
  

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:
	83 FR 6872	02/15/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 22284	05/14/2018
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
Application for Employment Authorization for Abused Nonimmigrant Spouse	I-765V	Application for Employment Authorization for Abused Nonimmigrant Spouse
Biometrics
Passport Style Photos

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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	1,000	3,000	0	-1,000	-1,000	0
Annual Time Burden (Hours)	2,460	4,500	0	-500	-1,540	0
Annual Cost Burden (Dollars)	125,000	265,000	0	-10,000	-130,000	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Although USCIS increased the average burden per response for this information collection as a result of additions to the form and instructions, the annual burden hours for this information collection have decreased by 2,040 hours. This change can be attributed to the elimination of the requirement for applicants to submit passport-style photographs, as well as a decrease in the estimated number of respondents. USCIS has added clarifying language to the form and instructions; is providing an opportunity for applicants to request a Social Security Number and/or Social Security card as part of their I-765V application; is requesting all countries of citizenship or nationality; and added biographic data elements to the form. The estimated annual cost burden to respondents for this information collection decreased as a result of the elimination of the requirement for applicants to submit passport-style photographs, as well as a decrease in the estimated number of respondents.

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Annual Cost to Federal Government: $190,000

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? No

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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: 01/31/2019

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