Instructions For Request For Reduced Fee (Form I-942) Page 7

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USCIS Privacy Act Statement
AUTHORITIES: The information requested on this request, and the associated evidence, is collected under the
Immigration and Nationality Act, section 286, and 8 CFR 103.7(b)(1)(i)(AAA)(1).
PURPOSE: The primary purpose for providing the requested information on this request is to determine if you have
established eligibility for the immigration benefit for which you are filing. The Department of Homeland Security (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 in your case or result in denial of your request and rejection of your
application or petition based on non-payment of the filing fee.
ROUTINE USES: DHS may share the information you provide on this request 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 Office of Management and Budget (OMB) control number. The
public reporting burden for this collection of information is estimated at 45 minutes per response, including the time
for reviewing instructions, gathering the required documentation and information, completing the request, preparing
statements, attaching necessary documentation, and submitting the request. 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. 1615-0133. Do not mail your completed Form I-942 to this address.
Form I-942 Instructions 12/23/16
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