Information Collection

Affidavit of Identifying Witness

IC 14904 under ICR 200902-1405-002 · OMB 1405-0088.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0088 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-71 Affidavit of Identifying Witness	Form
DS-71 Affadavit of Identifying Witness (3)DS0071-073108.pdf	Form
DS-71 Affidavit of Identifying Witness DS0071.pdf	Form and Instruction
Justification for Changes to the DS-71073108.docx Justification for Change to DS-71	IC Document

IC Title:

Affidavit of Identifying Witness

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 251

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-71	Affadavit of Identifying Witness	(3)DS0071-073108.pdf		Yes	No	Fillable Printable
Form and Instruction	DS-71	Affidavit of Identifying Witness	DS0071.pdf		No		Paper Only

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 163,300

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	163,300	23,300	140,000
Annual IC Time Burden (Hours)	13,608	1,908	11,700
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Change to DS-71	Justification for Changes to the DS-71073108.docx	07/31/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.