Information Collection

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

IC 203622 under ICR 201908-1405-003 · OMB 1405-0215.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0215 can be found here:

Documents and Forms

Document Name Document Type
Form DS-5520 Supplemental Questionnaire to Determine Identity for a U.S. Passport Form and Instruction
DS-5520 SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U DS-5520_30day_2019_Form (PDF)_FINAL.pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Questionnaire to Determine Identity 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 51.23,40,45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-5520	SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U.S. PASSPORT	DS-5520_30day_2019_Form (PDF)_FINAL.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: Passport Records, STATE-26	FR Citation: 81 FR 19863

Number of Respondents: 21,891	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	21,891	-60,456	82,347
Annual IC Time Burden (Hours)	16,418	-45,342	61,760
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.