Information Collection

Birth Affidavit

IC 15005 under ICR 202310-1405-003 · OMB 1405-0132.

Documents and Forms

Document Name Document Type
Form D-10 Birth Affidavit Form and Instruction
D-10 Birth Affidavit DS-10_30day_2020_Form_PDF Fillable.pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Birth Affidavit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 50, 51 (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	D-10	Birth Affidavit	DS-10_30day_2020_Form_PDF Fillable.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: 5,183	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-5,183	5,183
Annual IC Time Burden (Hours)	-3,455	3,455
Annual IC Cost Burden (Dollars)	-29,750	29,750

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.