Information Collection

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

IC 15051 under ICR 201309-1405-002 · OMB 1405-0160.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0160 can be found here:

Documents and Forms

Document Name Document Type
Form DS-5504 Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form and Instruction
DS-5504 Application for a U.S. Passport: Name Change, Data Corre DS-5504 Final Vers. A (1-14-2014).pdf www.travel.stste.gov Form and Instruction
DS-5504 Application for a U.S. Passport: Name Change, Data Corre OLD DS-5504 (3-1-2011).pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	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 Part 50 and 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-5504	Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	DS-5504 Final Vers. A (1-14-2014).pdf	www.travel.stste.gov	Yes	No	Fillable Printable
Form and Instruction	DS-5504	Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	OLD DS-5504 (3-1-2011).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:	FR Citation:

Number of Respondents: 114,637	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	114,637	-66,363	181,000
Annual IC Time Burden (Hours)	76,425	-14,075	90,500
Annual IC Cost Burden (Dollars)	2,821,216	-3,078,834	5,900,050

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.