Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-5504 Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	Form and Instruction	Modified	Available
DS-5504 Legal Authorities (07-2013).docx	Supplementary Document	Uploaded 2013-09-16	Available
DS-5504 Supporting Statement v2 (1-9-14).docx	Supporting Statement A	Uploaded 2014-01-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
15051	Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0160	ICR Reference No: 201309-1405-002
Status: Historical Active	Previous ICR Reference No: 201102-1405-005
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/15/2014
	Date Received in OIRA: 09/23/2013
Terms of Clearance: State is authorized to continue to use the previously approved version (2011) of the DS-5504 for 60 days until March 16, 2014. After that date, the 2011 version approval will expire and the new, revised form of the application will be the single, approved version of the DS-5504.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved	01/31/2014
Responses	114,637	0	181,000
Time Burden (Hours)	76,425	0	90,500
Cost Burden (Dollars)	2,821,216	0	5,900,050

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Abstract: The Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement (DS-5504) is the form used by current passport holders who need to re-apply for a new passport within one year of the date of issuance for the following conditions: a) the passport holder's name has changed within the first year of the issuance of the passport; b) the passport holder needs correction of descriptive information on the data page of the passport; c) the passport holder wishes to obtain a fully valid passport after obtaining a full-fee passport with a limited validity of two years or less.

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Authorizing Statute(s): US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 24782	04/26/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 58377	09/23/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement	DS-5504, DS-5504	Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement ,   Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement

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ICR Summary of Burden

table that charts list of burden

	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	114,637	181,000	0	0	-66,363	0
Annual Time Burden (Hours)	76,425	90,500	0	0	-14,075	0
Annual Cost Burden (Dollars)	2,821,216	5,900,050	0	0	-3,078,834	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Burden change due to decrease in number of respondents, elimination of fees incorrectly attributed to respondents in the last submission, and adjustment of time required to complete form.

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Annual Cost to Federal Government: $956,096

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/23/2013

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