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Federal forms, ICRs, and supporting documents

Information Collection Request

Supplemental Questionnaire to Determine Identity for a U.S. Passport

ICR 201208-1405-001 · OMB 1405-0215 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form DS-5520 Supplemental Questionnaire to Determine Identity for a U.S. Passport Form and Instruction New Repair queued
DS-5520 Supplemental Statement (6-2012).docx Supplementary Document Uploaded 2012-08-07 Repair queued
Legal Authorities - DS-5520 (6-2012).docx Supplementary Document Uploaded 2012-08-07 Available
DS-5520 Supporting Statement Final Draft (8-7-2013).docx Supporting Statement A Uploaded 2013-08-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
203622 Supplemental Questionnaire to Determine Identity for a U.S. Passport Form and Instruction New
ICR Details
1405-0215 201208-1405-001
Historical Active
STATE/AFA
Supplemental Questionnaire to Determine Identity for a U.S. Passport
Existing collection in use without an OMB Control Number   No
Regular
Approved with change 08/12/2013
Retrieve Notice of Action (NOA) 08/07/2012
  Inventory as of this Action Requested Previously Approved
08/31/2016 36 Months From Approved
69,647 0 0
52,235 0 0
0 0 0
The Supplemental Questionnaire to Determine Identity for a U.S. Passport is intended to verify the respondent's identity for purposes of determining eligibility for a U.S. passport. This form is used to supplement an existing passport application and solicits information relating to the respondent's employment and residences that is needed to corroborate an applicant's identity claim prior to passport issuance.
US Code: 8 USC 1201-1503 Name of Law: Immigration and Nationality Act
  
None
Not associated with rulemaking
  76 FR 67529 11/01/2011
77 FR 39317 07/02/2012
Yes
1
IC Title Form No. Form Name
Supplemental Questionnaire to Determine Identity for a U.S. Passport DS-5520, DS-5520 Supplemental Questionnaire to Determine Identity for a U.S. Passport
  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 69,647 0 0 69,647 0 0
Annual Time Burden (Hours) 52,235 0 0 52,235 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Burden change due to submission as new collection.
$12,600
No
No
No
No
No
Uncollected
Jeannette Mancus 202 663-1154
  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.
08/07/2012