View Information Collection Request (ICR) Package

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: 1405-0146	ICR Reference No: 201407-1405-006
Status: Historical Active	Previous ICR Reference No: 201202-1405-006
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Statement of Non-Receipt of a U.S. Passport
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/12/2014
	Date Received in OIRA: 07/22/2014
Terms of Clearance: OMB supports the efforts to make this form electronically available. State should continue to work towards electronic submission of this form in compliance with the Government Paperwork Elimination Act.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	09/30/2014
Responses	15,005	0	12,755
Time Burden (Hours)	3,751	0	1,063
Cost Burden (Dollars)	3,301	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	15,005	12,755	2,250
Annual Time Burden (Hours)	3,751	1,063	2,688
Annual Cost Burden (Dollars)	3,301	0	3,301

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: Burden changes due to increase in number of respondents and inclusion of additional travel time and costs for making photocopies.

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