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: 1405-0091	ICR Reference No: 201912-1405-003
Status: Historical Active	Previous ICR Reference No: 201701-1405-013
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Application to Determine Returning Resident Status
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: 05/11/2020
	Date Received in OIRA: 12/11/2019
Terms of Clearance: Previous TOC apply. The agency will update travel.state.gov (TSG) with guidancae on how to submit this collection and supporting documentation via email to the relevant U.S. Embassy or Consulate. Prior to resubmission of this ICR, the agency will update question #3 of the supporting statement to include describing the instruction verbiage used on TSG.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2023	36 Months From Approved	05/31/2020
Responses	4,400	0	4,400
Time Burden (Hours)	2,200	0	2,200
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $130,856

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: Ari Attar 202 485-7638

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