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OMB Control No: 1405-0236	ICR Reference No: 202602-1405-002
Status: Received in OIRA	Previous ICR Reference No: 202302-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: JADE Act Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2026
Responses	43,300	20,500
Time Burden (Hours)	21,650	10,250
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	43,300	20,500	2,300	20,500
Annual Time Burden (Hours)	21,650	10,250	1,150	10,250
Annual Cost Burden (Dollars)	0	0	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: The Department of State estimates that the annual hour burden to visa applicants as a result of this information collection is 11,400 hours (22,800 applicants x 30 minutes per response). Based on the average local monthly salary in Burma of $135 (or an hourly wage of $0.56), the total cost burden for this collection is $6,384 (11,400 hours x $0.56 hourly wage).

Annual Cost to Federal Government: $0

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. 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? No

Agency Contact: Dylan Aikens 202 485-7440

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