Information Collection

Application to Determine Returning Resident Status

IC 14917 under ICR 201009-1405-006 · OMB 1405-0091.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0091 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-117 Application to Determine Returning Resident Status	Form and Instruction
DS-117 Application to Determine Returning Resident Status ds0117.pdf www.travel.state.gov	Form and Instruction
DS-117 Application to Determine Returning Resident Status (9-20 DS-0117.pdf www.travel.state.gov	Form and Instruction

IC Title:

Application to Determine Returning Resident Status

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 42.22

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 and Instruction	DS-117	Application to Determine Returning Resident Status	ds0117.pdf	www.travel.state.gov	Yes	No	Fillable Printable
Form and Instruction	DS-117	Application to Determine Returning Resident Status (9-2010)	DS-0117.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 876

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	Previously Approved
Annual Number of Responses for this IC	875	875
Annual IC Time Burden (Hours)	438	438
Annual IC Cost Burden (Dollars)	315,000	315,000

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.