View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1405-0129
ICR Reference No:
201102-1405-003
Status:
Historical Active
Previous ICR Reference No:
200710-1405-005
Agency/Subagency:
STATE/AFA
Agency Tracking No:
Title:
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 16
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
02/23/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/08/2011
Terms of Clearance:
This form will expire on December 31, 2013 at the request of the Department of State.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2013
12/31/2013
02/28/2011
Responses
1,025,000
0
605,800
Time Burden (Hours)
1,025,000
0
605,800
Cost Burden (Dollars)
2,562,500
0
1,042,000
Abstract:
This form is used when both parents or legal guardians of a minor child under age 16 cannot be present at the time the minor's passport application is executed.
Authorizing Statute(s):
PL:
Pub.L. 106 - 113 Section 1000 (a)(7)),
Name of Law: Foreign Relations Authorization Act, Fiscal Year 2000 and 2001
US Code:
22 USC 211a
Name of Law: Authority to grant, issue, and verify passports
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
1400-AC28
Final or interim final rulemaking
72 FR 44
03/07/2007
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 118
06/21/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 197
10/13/2010
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 16
DS-3053, DS-3053, DS-3053, DS-3053
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 14
,
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 16
,
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 16
,
Statement of Consent or Special Circumstances: Issuance of a Passport to a Minor Under Age 16
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
1,025,000
605,800
0
0
419,200
0
Annual Time Burden (Hours)
1,025,000
605,800
0
0
419,200
0
Annual Cost Burden (Dollars)
2,562,500
1,042,000
0
0
1,520,500
0
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:
Change indicated is due to increase in number of respondents
Annual Cost to Federal Government:
$45,660
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
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:
Alexys Garcia 202 736-9216 garciaaa@state.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
02/08/2011
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