Information Collection

Statement of Non-Receipt of a Passport

IC 15031 under ICR 200902-1405-003 · OMB 1405-0146.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0146 can be found here:

Documents and Forms

Document Name Document Type
Form DS-86 Statement of Non-Receipt of a Passport Form
DS-86 Statement of Non-Receipt of a Passport DS-86 7-22-08.pdf Form
DS-86 Statement of Non-receipt of Passport DS-86.pdf www.travel.state.gov Form and Instruction
Justification for Changes to the DS-86.doc.docx Justification for Changes to DS-86 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement of Non-Receipt of a Passport	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 51.2(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-86	Statement of Non-Receipt of a Passport	DS-86 7-22-08.pdf		No		Fillable Printable
Form and Instruction	DS-86	Statement of Non-receipt of Passport	DS-86.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 27,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	27,400	3,900	23,500
Annual IC Time Burden (Hours)	2,283	283	2,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for Changes to DS-86	Justification for Changes to the DS-86.doc.docx	07/22/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.