Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons

Forms and Documents

Document Name	Status
Form I-914B Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified
Form I-914A Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified
Form I-914 Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified
I-914 REV Supporting Statement 20210218.docx Supporting Statement A	2021-03-30
I-914-006_30-Day_FRN 86 FR 13910_2021-05096.pdf Supplementary Document	2021-03-11
I-914-006_60-Day_85 FR-73290-2020-25265.pdf Supplementary Document	2021-03-11
I914SupB-006-INS-REV-30Day-02192021.pdf Supplementary Document	2021-02-22
I914SupB-006-FRM-TOC-REV-30Day-02172021.docx Supplementary Document	2021-02-19
I914SupA-006-FRM-TOC-REV-30Day-02172021.docx Supplementary Document	2021-02-19
I914-006-INS-REV-30Day-02192021.pdf Supplementary Document	2021-02-22
I914-006-FRM-TOC-REV-30Day-02172021.docx Supplementary Document	2021-02-19
Refrence Citation.doc Supplementary Document	2018-10-10
SORN - Benefits.pdf Supplementary Document	2018-10-10
SORN - A-File.pdf Supplementary Document	2018-10-10
PIA-CLAIMS 3.pdf Supplementary Document	2018-10-10

IC Document Collections

IC ID	Document Title	Status
225155	Biometrics Processing	Modified
211477	Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified
211476	Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified
21015	Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form	Modified

ICR Details

OMB Control No: 1615-0099	ICR Reference No: 202102-1615-004
Status: Received in OIRA	Previous ICR Reference No: 202007-1615-018
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-914
Title: Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/30/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2021
Responses	5,778	4,253
Time Burden (Hours)	9,261	6,284
Cost Burden (Dollars)	0	0

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Abstract: The information on all three parts of the form will be used to determine whether applicants meet the eligibility requirements for benefits. This application incorporates information pertinent to eligibility under the Victims of Trafficking and Violence Protection Act (VTVPA), Public Law 106-386, and a request for employment.

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Authorizing Statute(s): PL: Pub.L. 106 - 386 107(e) Name of Law: Victims of Trafficking and Violence Protection Act
  

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:
	85 FR 73290	11/17/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 13910	03/11/2021
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons	I-914	Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons
Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons	I-914A	Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons
Biometrics Processing
Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons	I-914B	Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons

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ICR Summary of Burden

	Total Request	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	5,778	4,253	0	854	671	0
Annual Time Burden (Hours)	9,261	6,284	0	2,192	785	0
Annual Cost Burden (Dollars)	0	0	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: There is an increase in the estimated annual hour burden due to an increase in the number of respondents across all collection instruments due to the increase in the estimated number of respondents provided by USCIS’ Service Center Operations Directorate (SCOPS) combined with an increase in estimated time burden of three of the four I-914 instruments: I-914 increases 0.3 hour per response, I-914A increased 0.083 hour per response, and I-914B increase 0.083 hour per response. This time burden increase is the result of adding clarifying information regarding trafficking, travel and other instructional clarifying language. Biometric Services hour burden increase is strictly due to the SCOPS estimate increase and is not associated with program change. There is an increase in the estimated annual out-of-pocket cost burden due to the increase in the number of respondents. This change did not occur as a result of the program changes provided by USCIS’ Service Center Operations Directorate (SCOPS).

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Annual Cost to Federal Government: $629,472

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: 03/30/2021

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