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: 1405-0215	ICR Reference No: 201908-1405-003
Status: Historical Active	Previous ICR Reference No: 201607-1405-006
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Updated - Supplemental Questionnaire to Determine Identity for 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 with change	Conclusion Date: 02/23/2021
	Date Received in OIRA: 08/27/2019
Terms of Clearance: The agency made clarifying edits to the supporting statements and ensured the information collection had available guidance and instructions online.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2024	36 Months From Approved	02/28/2021
Responses	21,891	0	82,347
Time Burden (Hours)	16,418	0	61,760
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	21,891	82,347	-60,456
Annual Time Burden (Hours)	16,418	61,760	-45,342
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: The program reflects a steep decrease in respondent’s use of this form from 82,347 to 21,891. This can be attributed to better and increased usage of backend databases that specialists use to verify an applicant’s identity, eliminating the need, in most cases, to send the particular IRLs that would include the DS-5520.

Annual Cost to Federal Government: $27,749

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

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? No

Agency Contact: Maya Badiat 202 485-6530

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