Application for additional VISA Pages

ICR 200506-1405-006

OMB: 1405-0159

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
15049 Migrated
ICR Details
1405-0159 200506-1405-006
Historical Active 200412-1405-004
STATE/AFA
Application for additional VISA Pages
Extension without change of a currently approved collection   No
Regular
Approved without change 08/22/2005
Retrieve Notice of Action (NOA) 06/27/2005
  Inventory as of this Action Requested Previously Approved
08/31/2008 08/31/2008 08/31/2005
30,000 0 30,000
10,000 0 10,000
422,000 0 422,000

This form will be used by U.S. citizens and non-citizen nationals who require additional visa pages to be added to their valid U.S. passport.

None
None


No

1
IC Title Form No. Form Name
Application for additional VISA Pages DS-4085

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 30,000 30,000 0 0 0 0
Annual Time Burden (Hours) 10,000 10,000 0 0 0 0
Annual Cost Burden (Dollars) 422,000 422,000 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/27/2005


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