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Federal forms, ICRs, and supporting documents

Information Collection Request

Statement of Consent or Special Circumstances: Issuance of a U.S. Passport to a Minor Under Age 14

ICR 200506-1405-004 · OMB 1405-0129 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
14999 Statement of Consent or Special Circumstances: Issuance of a U.S. Passport to a Minor Under Age 14 Form Migrated
ICR Details
1405-0129 200506-1405-004
Historical Active 200402-1405-006
STATE/AFA
Statement of Consent or Special Circumstances: Issuance of a U.S. Passport to a Minor Under Age 14
Revision of a currently approved collection   No
Regular
Approved without change 08/26/2005
Retrieve Notice of Action (NOA) 06/27/2005
  Inventory as of this Action Requested Previously Approved
08/31/2008 08/31/2008 08/31/2005
525,000 0 1,300,000
525,000 0 108,300
906,000 0 0
This form is used when both parents or legal guardians of a minor child under age 14 cannot be present at the time the minor's passport application is executed.
None
None
No
1
IC Title Form No. Form Name
Statement of Consent or Special Circumstances: Issuance of a U.S. Passport to a Minor Under Age 14 DS-3053
  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 525,000 1,300,000 0 0 -775,000 0
Annual Time Burden (Hours) 525,000 108,300 0 0 416,700 0
Annual Cost Burden (Dollars) 906,000 0 0 0 906,000 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/27/2005