Information Collection

Supplemental Questionnaire to Determine Entitlement for a U.S. Passport

IC 203623 under ICR 201607-1405-005 · OMB 1405-0214.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0214 can be found here:

Documents and Forms

Document Name Document Type
Form DS-5513 Supplemental Questionnaire to Determine Entitlement for a U.S. Passport Form and Instruction
DS-5513 Supplemental Questionnaire to Determine Entitlement for DS-5513 06-9-2016 OIRA.pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Questionnaire to Determine Entitlement for a U.S. Passport	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 51.23, 51.40, 51.45 22 CFR 50, B&C (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-5513	Supplemental Questionnaire to Determine Entitlement for a US passport	DS-5513 06-9-2016 OIRA.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: 3,257	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	Previously Approved
Annual Number of Responses for this IC	3,257	2,112	1,145
Annual IC Time Burden (Hours)	4,614	2,992	1,622
Annual IC Cost Burden (Dollars)	0	0	0

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.