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Form I-690 Instructions - Application For Waiver Of Grounds Of Inadmissibility - Department Of Homeland Security Page 8

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this application and the associated evidence, is collected under the

Immigration and Nationality Act, Section 210 and 245A, the Immigration Reform and Control Act of 1986, and section

902 of the U.S. Department of State Authorization Bill of 1987.

PURPOSE: The primary purpose for providing the requested information on this application is to determine if you have

established eligibility for the immigration benefit for which you are filing. DHS will use the information you provide to

grant or deny the immigration benefit you are seeking.

DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and

any requested evidence, may delay a final decision or result in denial of your request for a waiver of inadmissibility.

ROUTINE USES: DHS may share the information you provide on this application 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/USCIS-007 - Benefits Information System and DHS/USCIS-001 -

Alien File, Index, and National File Tracking System of Records] which you can find at DHS

may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.

Paperwork Reduction Act

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 collection of

information is estimated at 3 hours per response in paper format, including the time for reviewing instructions, gathering the

required documentation and information, completing the application, preparing the statement, attaching necessary

documentation, and submitting the application. Send comments regarding this burden estimate or any other aspect of this

collection of information, including suggestions for reducing this burden to: U.S. Citizenship and Immigration Services,

Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140;

OMB No. 1615-0032. Do not mail your completed Form I-690 to this address.

Form I-690 Instructions 12/23/2016 N

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Form I-690 Instructions - Application For Waiver Of Grounds Of Inadmissibility - Department Of Homeland Security Page 8