Information Collection

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

IC 14809 under ICR 202109-1405-001 · OMB 1405-0014.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form DS-64 Statement Regarding a Lost or Stolen Passport Book and/or Card Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card Form and Instruction
DS-64 Online Screenshots 2018.pdf travel.state.gov Other-Web Application for DS-64
DS-64 Online Screenshots 2018.pdf travel.state.gov Other-Web Application for DS-64
DS-64 Statement Regarding a Lost or Stolen Passport Book and/o Form DS-64_OMB No 1405-0014.pdf Form and Instruction
DS-64 Statement Regarding a Lost or Stolen Passport Book and/o Form DS-64_OMB No 1405-0014.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card	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 51.8(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Application for DS-64			DS-64 Online Screenshots 2018.pdf	travel.state.gov	Yes	Yes	Fillable Fileable
Form and Instruction	DS-64	Statement Regarding a Lost or Stolen Passport Book and/or Card	Form DS-64_OMB No 1405-0014.pdf		Yes	No	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 643,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	643,400	643,400
Annual IC Time Burden (Hours)	53,617	53,617
Annual IC Cost Burden (Dollars)	4,632	4,632

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.

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