Information Collection

Statement Regarding Lost or Stolen Passport

IC 14809 under ICR 200902-1405-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form DS-64 Statement Regarding a Lost or Stolen Passport Statement Regarding Lost or Stolen Passport	Form
Form DS-64 Statement Regarding a Lost or Stolen Passport Statement Regarding Lost or Stolen Passport	Form and Instruction
DS-64 Statement Regarding a Lost or Stolen Passport (6)DS0064-073108.pdf	Form
DS-64 Statement Regarding a Lost or Stolen Passport DS0064.pdf	Form and Instruction

IC Title:

Statement Regarding Lost or Stolen Passport

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-64				No		Printable Only
Form and Instruction	DS-64			www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 122,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	122,500	17,500	105,000
Annual IC Time Burden (Hours)	10,208	1,408	8,800
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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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