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:
1405-0178
ICR Reference No:
202002-1405-003
Status:
Historical Active
Previous ICR Reference No:
201701-1405-014
Agency/Subagency:
STATE/AFA
Agency Tracking No:
Title:
Request for Determination of Possible Loss of United States Citizenship
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:
06/10/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/25/2020
Terms of Clearance:
Agency made revisions to the supporting statement to provide additional clarity regarding the processes associated with this information collection and the estimation of burden associated with this information collection.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2023
36 Months From Approved
06/30/2020
Responses
3,250
0
600
Time Burden (Hours)
5,688
0
400
Cost Burden (Dollars)
63,521
0
0
Abstract:
The purpose of the DS-4079 questionnaire is to determine current citizenship status and the possibility of loss of United States citizenship. The information provided assists consular officers and the Department of State in determining if the U.S. citizen has lost his or her nationality by voluntarily performing an expatriating act with the intention of relinquishing United States nationality.
Authorizing Statute(s):
US Code:
8 USC 1481(a)
Name of Law: Immigration and Nationality Act (INA)
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
84 FR 57545
10/25/2019
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 10806
02/25/2020
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Request for Determination of Possible Loss of United States Citizenship
DS-4079
Request for Determination of Possible Loss of United States Citizenship
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
3,250
600
0
2,650
0
0
Annual Time Burden (Hours)
5,688
400
0
5,288
0
0
Annual Cost Burden (Dollars)
63,521
0
0
63,521
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Based on the average number of respondents in the past 3 years (FY16-FY18), the number of respondents increased to 3,250 resulting in an associated increase in burden to 812 hours. The reason the number of respondents changed is because the number of respondents that complete the form varies from year to year depending on the number of citizens who may have relinquished their U.S. citizenship. Cost burden has increased due to the number of respondents on average that submit the DS-4079. The cost burden of $63,521 was not included in previous iterations of the Supporting Statement.
Annual Cost to Federal Government:
$61,812
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:
Clifton Oliphant 202 485-6020
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:
02/25/2020
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