Information Collection

Application for Additional Visa Pages or Miscellaneous Passport Services

IC 15049 under ICR 201308-1405-007 · OMB 1405-0159.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-4085 Application for Additional Visa Pages or Miscellaneous Passport Services	Form and Instruction
DS-4085 Application for Additional Visa Pages or Miscellaneous P DS-4085 (08-2013).pdf www.travel.state.gov	Form and Instruction

IC Title:

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 50-51 (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-4085	Application for Additional Visa Pages or Miscellaneous Passport Services	DS-4085 (08-2013).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: Passport Records (State-26)

FR Citation: 76 FR 129

Number of Respondents: 68,559

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	68,559	0	-77,441	146,000
Annual IC Time Burden (Hours)	22,853	0	-25,814	48,667
Annual IC Cost Burden (Dollars)	85,700	-17,559,600	0	17,645,300

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.