Information Collection

Departure Notification Record

IC 274256 under ICR 202503-1653-001 · OMB 1653-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1653-0057 can be found here:

Documents and Forms

Document Name Document Type
Mockups_CBP GO_Departing Traveler_Submit Intent to Depart.pptx Other-Mockup
CBP Home_Departing Traveler_Submit Intent to Depart.pdf Other-Mockup

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Departure Notification Record	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Mockup			CBP Home_Departing Traveler_Submit Intent to Depart.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,800,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16,800,000	16,800,000
Annual IC Time Burden (Hours)	1,394,400	1,394,400
Annual IC Cost Burden (Dollars)	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.