Information Collection

Application for Additional Visa Pages or Miscellaneous Passport Services

IC 15049 under ICR 201308-1405-007 · OMB 1405-0159.

Documents and Forms

Document Name Document Type
Form DS-4085 Application for Additional Visa Pages or Miscellaneous Passport Services Form and Instruction
DS-4085 Application for Additional Visa Pages or Miscellaneous P DS-4085 (08-2013).pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Additional Visa Pages or Miscellaneous Passport Services	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 50-51 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-4085	Application for Additional Visa Pages or Miscellaneous Passport Services	DS-4085 (08-2013).pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: Passport Records (State-26)	FR Citation: 76 FR 129

Number of Respondents: 68,559	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	68,559	0	-77,441	146,000
Annual IC Time Burden (Hours)	22,853	0	-25,814	48,667
Annual IC Cost Burden (Dollars)	85,700	-17,559,600	0	17,645,300

Documents for IC

Title	Document	Date Uploaded
No associated records found

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