Information Collection

Supplemental Questionnaire to Determine Entitlement for a U.S. Passport

IC 203623 under ICR 201208-1405-002 · OMB 1405-0214.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0214 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-5513 Supplemental Questionnaire to Determine Entitlement for a U.S. Passport	Form and Instruction
DS-5513 Supplemental Questionnaire to Determine Entitlement for DS-5513 Entitlement Questionnaire (6-2012).pdf	Form and Instruction
DS-5513 Supplemental Questionnaire to Determine Entitlement for DS-5513 Entitlement Questionnaire revised (7-2013).pdf www.travel.state.gov	Form and Instruction

IC Title:

Supplemental Questionnaire to Determine Entitlement for a U.S. Passport

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 50, B&C 22 CFR 51.23, 51.40, 51.45 (To search for a specific CFR, visit the Code of Federal Regulations.)

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-5513	Supplemental Questionnaire to Determine Entitlement for a U.S. Passport	DS-5513 Entitlement Questionnaire (6-2012).pdf		Yes	No	Fillable Printable
Form and Instruction	DS-5513	Supplemental Questionnaire to Determine Entitlement for a U.S. Passport	DS-5513 Entitlement Questionnaire revised (7-2013).pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,145

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,145	1,145
Annual IC Time Burden (Hours)	1,622	1,622
Annual IC Cost Burden (Dollars)	0	0

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.