OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Request for Determination of Possible Loss of United States Citizenship

ICR 201701-1405-014 · OMB 1405-0178 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form DS-4079 Request for Determination of Possible Loss of United States Citizenship Form and Instruction Modified Available
DS-4079 Legal Authorities.doc Supplementary Document Uploaded 2017-01-17 Repair queued
FINAL - DS-4079 Supporting Statement.doc Supporting Statement A Uploaded 2017-01-17 Available
IC Document Collections
IC IDCollectionTypeStatusForm
181472 Request for Determination of Possible Loss of United States Citizenship Form and Instruction Modified
ICR Details
1405-0178 201701-1405-014
Historical Active 201310-1405-003
STATE/AFA
Request for Determination of Possible Loss of United States Citizenship
Extension without change of a currently approved collection   No
Regular
Approved without change 02/28/2017
Retrieve Notice of Action (NOA) 01/17/2017
  Inventory as of this Action Requested Previously Approved
02/29/2020 36 Months From Approved 02/28/2017
600 0 1,729
400 0 432
0 0 32,532
The purpose of the DS-4079 questionnaire is to determine current citizenship status and the possibility of loss of United States citizenship. The information provided assists consular officers and the Department of State in determining if the U.S. citizen has lost his or her nationality by voluntarily performing an expatriating act with the intention of relinquishing United States nationality.
US Code: 8 USC 1481(a) Name of Law: Immigration and Nationality Act (INA)
  
None
Not associated with rulemaking
  81 FR 52945 08/10/2016
82 FR 4449 01/13/2017
No
  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 600 1,729 0 -1,129 0 0
Annual Time Burden (Hours) 400 432 0 -32 0 0
Annual Cost Burden (Dollars) 0 32,532 0 -32,532 0 0
No
Yes
Miscellaneous Actions
The number of applicants varies from year to year depending on the number of citizens who may have relinquished their U.S. citizenship. The Department reevaluated the time it takes for applicants to complete the DS-4079 and determined that the increase from 15 minutes to 40 minutes is a more fair representation of applicants’ efforts. This change is based on a feedback we received from U.S. diplomatic missions abroad. The cost to the respondent shows a difference of 32,532 because the cost of the respondent has changed from $32,532 to zero. Consular Affairs has stated there are no required costs associated with the respondent delivering the form to a U.S. diplomatic mission ahead of his/her interview. The applicant may choose to email the unsigned form or send the unsigned form via mail to the U.S. diplomatic mission ahead of their interview, but not required.
$8,071,738
No
No
No
No
No
Uncollected
Derek Rivers 202 736-9082 [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.
01/17/2017