Statement Regarding a Lost or Stolen Passport Book and/or Card

ICR 201103-1405-005

OMB: 1405-0014

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2011-03-16
Supplementary Document
2009-02-09
Supporting Statement A
2011-03-16
Justification for No Material/Nonsubstantive Change
2008-07-31
IC Document Collections
ICR Details
1405-0014 201103-1405-005
Historical Active 200902-1405-001
STATE/AFA
Statement Regarding a Lost or Stolen Passport Book and/or Card
Extension without change of a currently approved collection   No
Regular
Approved with change 05/09/2011
Retrieve Notice of Action (NOA) 03/16/2011
Approved for two years only due to lack of GPEA complaince. OMB requests that DOS pursue development of an electronically fillable Form DS-64 and also a means of accepting electronic submission. DOS may be eligible for a full three year extension once an electronic fillable form and electronic signature option are publicly available. OMB also requests that DOS review the form and Privacy Act statement and at least six months prior to resubmission, update OMB on full compliance with the Plain Writing Act of 2010.
  Inventory as of this Action Requested Previously Approved
05/31/2013 36 Months From Approved 05/31/2011
122,500 0 122,500
10,208 0 10,208
0 0 0

The form is used prior to passport issuance and solicits information relating to the loss or theft of a valid U.S. passport. The information is used by the United States Department of State to ensure that no person shall bear more than one valid or potentially valid U.S. passport book and passport card at any one time, except as authorized by the Department, and is also used to combat passport fraud and misuse.

US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
  
None

Not associated with rulemaking

  75 FR 245 12/22/2010
76 FR 48 03/11/2011
Yes

  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 122,500 122,500 0 0 0 0
Annual Time Burden (Hours) 10,208 10,208 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
No
No
No
Uncollected
Alexys Garcia 202 736-9216 [email protected]

  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.
03/16/2011


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