OMB control number

Crisis Assistance Request Form - (Dept. of State)

OMB 1405-0259 · STATE/AFA.

OMB 1405-0259

The purpose of the collection is to enable the Department of State to better identify and communicate with U.S. citizens and Lawful Permanent Residents (LPRs) who may need consular assistance during a crisis overseas.

The latest form for Crisis Assistance Request Form - (Dept. of State) expires 2026-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Crisis Assistance Request Form Form and Instruction
Change Required 1405-0259.docx Justification for No Material/Nonsubstantive Change
CACMS Privacy Act Statement (002).docx Supplementary Document
30 Day FRN.pdf Supplementary Document
2022-22211.pdf Supplementary Document
Crisis Form - Legal Authorities (2-28-22) - Copy.docx Supplementary Document
Supporting Statement - Generic Online form (final) (28-jun) (004).docx Supporting Statement A
Crisis Assistance Request Form - (Dept. of State) Form and Instruction
Crisis Assistance Request Form - (Dept. of State) Other-Requested change

All Historical Document Collections

202506-1405-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2025-06-24
202306-1405-004 Approved with change	New collection (Request for a new OMB Control Number)	2023-06-28