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OMB Control No: 1405-0153	ICR Reference No: 202603-1405-003
Status: Received in OIRA	Previous ICR Reference No: 202205-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Electronic Diversity Visa Entry Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/17/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	11,072,400	11,072,400
Time Burden (Hours)	5,536,200	5,536,200
Cost Burden (Dollars)	55,362,000	55,362,000

ICR Summary of Burden

	Total Request	Previously Approved
Annual Number of Responses	11,072,400	11,072,400
Annual Time Burden (Hours)	5,536,200	5,536,200
Annual Cost Burden (Dollars)	55,362,000	55,362,000

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:

Annual Cost to Federal Government: $3,478,946

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: Tonya Whigham 202 485-7635

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