You are about to access a Department of Homeland Security computer system. This computer system and data therein are property of the U.S. Government and provided for official U.S. Government information and use. There is no expectation of privacy when you use this computer system. The use of a password or any other security measure does not establish an expectation of privacy. By using this system, you consent to the terms set forth in this notice. You may not process classified national security information on this computer system. Access to this system is restricted to authorized users only. Unauthorized access, use, or modification of this system or of data contained herein, or in transit to/from this system, may constitute a violation of section 1030 of title 18 of the U.S. Code and other criminal laws. Anyone who accesses a Federal computer system without authorization or exceeds access authority, or obtains, alters, damages, destroys, or discloses information, or prevents authorized use of information on the computer system, may be subject to penalties, fines or imprisonment. This computer system and any related equipment is subject to monitoring for administrative oversight, law enforcement, criminal investigative purposes, inquiries into alleged wrongdoing or misuse, and to ensure proper performance of applicable security features and procedures. DHS may conduct monitoring activities without further notice.
The information and associated evidence you provide is collected pursuant to the Immigration and Nationality Act of 1952 (P.L. 82–414), as amended; the Homeland Security Act of 2002 (P.L. 107–296); and Title 8 of the Code of Federal Regulations.
The primary purpose of providing the requested information on this form is to create or update your USCIS Account. Once you create a USCIS Account and submit an application or petition, DHS uses the information you provide to: (1) determine eligibility for a requested benefit which includes required national security and law enforcement checks; or (2) determine eligibility to act as an attorney or accredited representative in USCIS on behalf of individuals filing immigration benefits with USCIS; and/or (3) associate yourself with a particular application or petition or applicant or petitioner.
The information you provide is voluntary. However, failure to provide information may prevent you from creating an online account ultimately limiting your ability to electronically file your application or petition. Please note that the system will record user information such as Internet Protocol Address and Web Browser type and version upon submission.
DHS may share the information you provide on this form with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/ALL-037 E Authentication Records System of Records] and the published privacy impact assessments, which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security.
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for this information collection is estimated at .167 hour per response. This time burden estimation includes the time for gathering the required documentation and information, reviewing the instructions, and completing and submitting the request. Send comments regarding the burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to:
U.S. Citizenship and Immigration Services
Regulatory Coordination Division, Office of Policy and Strategy
20 Massachusetts Ave. N.W.
Washington, D.C 20529-2140
OMB Control No. 1615-0122.
Expiration Date: 8/31/2018
Do not mail your completed request to this address.