Instructions For Form I-854 - Inter-Agency Alien Witness And Informant Record Page 6

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DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information and any
requested evidence, may delay a final decision in your case or result in denial of your form for S nonimmigrant status for
the alien.
ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, foreign
government agencies, and authorized organizations in accordance with approved routine uses, as described in the associated
published system of records notices [DHS/USCIS-001 – Alien File, Index, and National File Tracking System of Records],
which can be found at DHS may also make the information available, 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 on Form I-854A and 1 hour per response on Form I-854B, including the
time for reviewing instructions and completing and submitting the form. 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. 1615-0046. Do not mail your completed form to this address.
Form I-854AB Instructions 07/13/17 N
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