I-192-018 83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS-USCIS

0017
1615
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___ ___ - ___
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Enter only items that change
Current record

New record

Agency form number (s)

I-192

Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%

Total annual hours
Difference
Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

USCIS is requesting OMB approval of a non-substantive change to update the form and instructions to comply with Executive
Order 14168, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal
Government. These changes include replacing the term “gender” with “sex” and requiring an individual's sex list male or
female and not requesting gender identity.
Signature of Senior Official or designee:
Date:
For OIRA Use
___________________________________
JERRY L
___________________________________
02/18/2025

RIGDON

Digitally signed by JERRY L RIGDON
Date: 2025.02.18 12:18:58 -05'00'

** This form cannot be used to extend an expiration date.

OMB 83-C

10/95