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Federal forms, ICRs, and supporting documents

Information Collection Request

Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement

ICR 201309-1405-002 · OMB 1405-0160 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form DS-5504 Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form and Instruction Modified Repair queued
DS-5504 Legal Authorities (07-2013).docx Supplementary Document Uploaded 2013-09-16 Available
DS-5504 Supporting Statement v2 (1-9-14).docx Supporting Statement A Uploaded 2014-01-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
15051 Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form and Instruction Modified
ICR Details
1405-0160 201309-1405-002
Historical Active 201102-1405-005
STATE/AFA
Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement
Revision of a currently approved collection   No
Regular
Approved with change 01/15/2014
Retrieve Notice of Action (NOA) 09/23/2013
State is authorized to continue to use the previously approved version (2011) of the DS-5504 for 60 days until March 16, 2014. After that date, the 2011 version approval will expire and the new, revised form of the application will be the single, approved version of the DS-5504.
  Inventory as of this Action Requested Previously Approved
01/31/2017 36 Months From Approved 01/31/2014
114,637 0 181,000
76,425 0 90,500
2,821,216 0 5,900,050
The Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement (DS-5504) is the form used by current passport holders who need to re-apply for a new passport within one year of the date of issuance for the following conditions: a) the passport holder's name has changed within the first year of the issuance of the passport; b) the passport holder needs correction of descriptive information on the data page of the passport; c) the passport holder wishes to obtain a fully valid passport after obtaining a full-fee passport with a limited validity of two years or less.
US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
  
None
Not associated with rulemaking
  78 FR 24782 04/26/2013
78 FR 58377 09/23/2013
Yes
  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 114,637 181,000 0 0 -66,363 0
Annual Time Burden (Hours) 76,425 90,500 0 0 -14,075 0
Annual Cost Burden (Dollars) 2,821,216 5,900,050 0 0 -3,078,834 0
No
No
Burden change due to decrease in number of respondents, elimination of fees incorrectly attributed to respondents in the last submission, and adjustment of time required to complete form.
$956,096
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.
09/23/2013