Information Collection

Application for Replacement Naturalization/Citizenship Document

IC 20426 under ICR 201206-1615-007 · OMB 1615-0091.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0091 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form N-565 Application for Replacement Naturalization/Citizenship Document	Form
N565-INS-DHSReview-07182012.pdf	Instruction
N-565 Application for Replacement Naturalization/Citizenship D N565-FRM-DHSReview-07182012.pdf	Form

IC Title:

Application for Replacement Naturalization/Citizenship Document

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 343

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	N-565	Application for Replacement Naturalization/Citizenship Document	N565-FRM-DHSReview-07182012.pdf		Yes	No	Fillable Printable
Instruction			N565-INS-DHSReview-07182012.pdf		Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: United States Citizenship and Immigration Services Benefits Information System

FR Citation: 73 FR 56596

Number of Respondents: 29,298

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	29,298	0	29,298
Annual IC Time Burden (Hours)	26,836	0	26,836
Annual IC Cost Burden (Dollars)	0	-10,107,810	10,107,810

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.