Form DS-7675 Foreign Mission Emergency Afterhours Contact

U.S. Department of State

FOREIGN MISSION EMERGENCY AFTER-HOURS CONTACT

OMB NO. xxxx-xxxx
EXPIRES: xx/xx/20xx
Estimated Burden: xx Minutes*

Emergency management is a discipline that involves preparing for a disaster before it occurs, responding to it (i.e., emergency evacuation), and
assisting after the disaster has occurred. For prompt contact with embassies and consulates to ensure the Department of State can deliver information
and guidance in the event of an emergency, the Office of Foreign Missions is requesting afterhours emergency contact information of the senior officials
for all diplomatic and consular missions in the United States. All information is treated as sensitive and will be shared only with agencies assigned to
assist during a crisis situation. To that end, the Department would appreciate the following information:

GENERAL INFORMATION (Please type or print the information requested in the spaces below)
1. From (Name of Country/Organization)

3. Mission Working Hours

2. Mission Physical Address

4. Mission Phone Number

5. Mission Fax Number

CONTACT INFORMATION
Provide the names, titles, after-hours phone numbers (including area codes), and emails of at least two Senior Officials (e.g., Ambassador, Consul
General, etc.) who can be reached in the event of an emergency.
6. First Contact
Name

Title

Home Email

Home Phone Number

Cell Phone Number

Home Fax Number

Name

Title

Home Email

Home Phone Number

Cell Phone Number

Home Fax Number

Name

Title

Home Email

Home Phone Number

Cell Phone Number

Home Fax Number

Duty Officer Title

Duty Officer Phone Number

7. Second Contact

8. Third Contact (Optional)

9. 24-Hour Duty Office
Duty Officer Name

Comments (If this is a rotational responsibility, please note and provide details.)

PAPERWORK REDUCTION ACT STATEMENT
*Public reporting burden for this collection of information is estimated to average xx minutes per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202.
DS-7675
xx-xxxx