View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1615-0060	ICR Reference No: 201809-1615-001
Status: Historical Active	Previous ICR Reference No: 201702-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No: N-648
Title: Medical Certification for Disability Exceptions
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/23/2019
	Date Received in OIRA: 02/27/2019
Terms of Clearance: Approved for two years only due to partial GPEA compliance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved	05/31/2019
Responses	4,138	0	17,302
Time Burden (Hours)	8,276	0	34,604
Cost Burden (Dollars)	202,762	0	912,681

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	4,138	17,302	-13,164
Annual Time Burden (Hours)	8,276	34,604	-26,328
Annual Cost Burden (Dollars)	202,762	912,681	-709,919

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 26,328 decrease in the annual burden hours associated with this collection that results from a decrease in the estimated population. There is a $709,919 decrease in the estimated total annual cost burden associated with this information collection that results from decrease in the estimated population. There is no program change; however the Privacy Notice has been updated.

Annual Cost to Federal Government: $1,391,558

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: Megan Barker 202 272-9135 megan.m.barker@uscis.dhs.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.