View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1615-0033	ICR Reference No: 201901-1615-011
Status: Historical Active	Previous ICR Reference No: 201710-1615-001
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-693
Title: Report of Medical Examination and Vaccination Record
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/15/2019
	Date Received in OIRA: 02/08/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	36 Months From Approved	07/31/2019
Responses	667,000	0	574,000
Time Burden (Hours)	1,667,500	0	1,435,000
Cost Burden (Dollars)	329,331,250	0	283,412,500

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	667,000	574,000	93,000
Annual Time Burden (Hours)	1,667,500	1,435,000	232,500
Annual Cost Burden (Dollars)	329,331,250	283,412,500	45,918,750

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 has been an increase in the estimated time burden for this collection of information. The increase is due to the increase in the number of respondents from 574,000 to 667,000. USCIS removed information regarding tuberculin skin testing from Form I-693 and its instructions, and made clarifying edits to the form and instructions. These changes did not affect the time burden estimate for this information collection. There has been an increase in the estimated time burden for this collection of information. The increase is due to the increase in the number of respondents from 574,000 to 667,000. The changes USCIS made to the form and instructions did not affect the cost burden estimate for this information collection.

Annual Cost to Federal Government: $42,130,634

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: Kerstin Jager 214 489-8022 kerstin.a.jager@uscis.dhs.gov

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