Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card

ICR 201507-1405-004 · OMB 1405-0014 · Historical Inactive

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1405-0014 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form DS-64 Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card	Form and Instruction	Modified	Repair queued
Justification for Non-sub submission (DS-64, 1405-0014) 7-2015.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-07-30	Repair queued
Legal Authorities (5-2015).docx	Supplementary Document	Uploaded 2015-05-26	Repair queued
DS-64 Supporting Statement(5-2015).docx	Supporting Statement A	Uploaded 2015-05-26	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
14809	Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card	Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0014	ICR Reference No: 201507-1405-004
Status: Historical Inactive	Previous ICR Reference No: 201505-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 09/17/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/30/2015
Terms of Clearance: Department of State may resubmit this request when it has final versions of the instruments of information collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	06/30/2018	06/30/2018
Responses	527,334	0	527,334
Time Burden (Hours)	87,889	0	87,889
Cost Burden (Dollars)	47,560	0	47,560

Abstract: The form is used prior to passport issuance and solicits information relating to the loss or theft of a valid U.S. passport. The information is used by the U.S. Department of State to ensure that no person shall bear more than one valid or potentially valid U.S. passport book and/or card at any one time, except as authorized by the Department, and is also used to combat passport fraud and misuse.

Authorizing Statute(s): US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 6566	02/05/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 30107	05/26/2015
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card	DS-64, DS-64	Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card , Lost or Stolen Passport Book or Card - Pilot Screenshots

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $1,998,739

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Alexys Garcia 202 736-9216 [email protected]

Common Form ICR: No