OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Replacement Naturalization/Citizenship Document

ICR 201502-1615-015 · OMB 1615-0091 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form N-565 Application for Replacement Naturalization/Citizenship Document Form Modified Repair queued
N565-INS-TOC-30Day-04062015.doc Supplementary Document Uploaded 2015-04-23 Repair queued
N565-FRM-TOC-30Day-04062015.doc Supplementary Document Uploaded 2015-04-23 Available
Supporting Statement N-565 2015-5-7.doc Supporting Statement A Uploaded 2015-05-07 Available
PIA.pdf Supplementary Document Uploaded 2015-02-25 Available
sorn.docx Supplementary Document Uploaded 2015-02-25 Repair queued
30-day FRN.pdf Supplementary Document Uploaded 2015-02-25 Available
60-day FRN pub 2014-10-30 1615-0091 N-565.pdf Supplementary Document Uploaded 2015-02-25 Available
N-565 reference.doc Supplementary Document Uploaded 2015-02-25 Available
IC Document Collections
IC IDCollectionTypeStatusForm
20426 Application for Replacement Naturalization/Citizenship Document Form Modified
ICR Details
1615-0091 201502-1615-015
Historical Active 201206-1615-007
DHS/USCIS N-565
Application for Replacement Naturalization/Citizenship Document
Revision of a currently approved collection   No
Regular
Approved with change 05/07/2015
Retrieve Notice of Action (NOA) 02/27/2015
Approved for two years due to partial GPEA compliance.
  Inventory as of this Action Requested Previously Approved
05/31/2017 36 Months From Approved 05/31/2015
29,298 0 29,298
26,836 0 26,836
3,589,005 0 0
This form is used by USCIS to determine an applicant's eligibility for a replacement document that was lost, mutilated or destroyed, or if the applicant's name was changed by marriage or by court order after the original document was issued. Additionally, this form is used by a naturalized citizen applicant who desires to obtain a special certificate of recognition as a citizen of the United States by a foreign country.
US Code: 8 USC 1454 Name of Law: U.S. Code
  
None
Not associated with rulemaking
  79 FR 64612 10/30/2014
80 FR 9742 02/24/2015
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 29,298 29,298 0 0 0 0
Annual Time Burden (Hours) 26,836 26,836 0 0 0 0
Annual Cost Burden (Dollars) 3,589,005 0 0 0 3,589,005 0
No
No
$10,107,810
No
No
No
No
No
Uncollected
John Ramsay 202 646-4247 [email protected]
  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.
02/27/2015