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View ICR - OIRA Conclusion

OMB Control No: 1615-0033	ICR Reference No: 201710-1615-001
Status: Historical Active	Previous ICR Reference No: 201703-1615-004
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-693
Title: Report of Medical Examination and Vaccination Record
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: 10/19/2017
	Date Received in OIRA: 10/04/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	02/28/2019	02/28/2019
Responses	574,000	0	574,000
Time Burden (Hours)	1,435,000	0	1,435,000
Cost Burden (Dollars)	283,412,500	0	283,412,500

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	574,000	574,000
Annual Time Burden (Hours)	1,435,000	1,435,000
Annual Cost Burden (Dollars)	283,412,500	283,412,500

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: No

Burden Reduction Due to:

Short Statement: There is a decrease in the estimated public cost burden associated with this information collection, resulting from a lower agency estimate on adjustments of status filings and therefore, adjusting the estimated out-of-pocket costs that respondents may incur to obtain medical examinations. There has been a decrease of 115,610 hours in the total estimated annual burden hours previously reported for this information collection, from 1,550,610 to 1,435,000. This decrease can be attributed to the decrease in the number of respondents from 620,244 respondents to 574,000. The decrease in the number of respondents is based on the five year average of the number of respondents for the I-485 received by USCIS, for which an I-693 is required for adjustment of status.

Annual Cost to Federal Government: $36,271,634

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

Agency Contact: Heather Young 202 272-1673 heather.l.young@uscis.dhs.gov

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