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Application for Cancellation of Removal for Certain Lawful Permanent Residents
Application for Cancellation of Removal (42a) for Certain Permanent Residents; (42b) and Adjustment of Status for Certain Nonpermanent Residents
OMB: 1125-0001
IC ID: 12667
OMB.report
DOJ/EOIR
OMB 1125-0001
ICR 202210-1125-003
IC 12667
( )
Documents and Forms
Document Name
Document Type
Form EOIR-42A
Application for Cancellation of Removal for Certain Lawful Permanent Residents
Form and Instruction
EOIR-42A Application for Cancellation of Removal for Lawful Perma
eoir-42a_Aug 2022_final(2).pdf
Form and Instruction
EOIR-42A Application for Cancellation of Removal for Lawful Perma
eoir-42a_Aug 2022_final(2).pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Cancellation of Removal for Certain Lawful Permanent Residents
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
8 CFR 1240.20
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
EOIR-42A
Application for Cancellation of Removal for Lawful Permanent Residents
eoir-42a_Aug 2022_final(2).pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Judicial Hearing
Privacy Act System of Records
Title:
EOIR-001 Records Management and Information System
FR Citation:
69 FR 26179
Number of Respondents:
2,082
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,082
0
-25,917
0
0
27,999
Annual IC Time Burden (Hours)
12,145
0
-150,249
0
0
162,394
Annual IC Cost Burden (Dollars)
208,200
0
208,200
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.