SUPPORTING STATEMENT FOR PAPERWORK REDUCTION ACT SUBMISSION
APPLICATION
FOR A U.S. PASSPORT: NAME CHANGE, DATA CORRECTION, AND LIMITED
PASSPORT BOOK REPLACEMENT
OMB
Control Number #1405-0160
(Form DS-5504)
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, at no charge, within one year of the original passport’s issuance. The following categories are permitted to re-apply for a new passport, within one year of the date of issuance, and at no charge: 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.
Under 22 United States Code (U.S.C.) Section 211a et seq. and Executive Order 11295 (August 5, 1966), the Secretary of State has authority to issue U.S. passports to U.S. citizens and non-citizen nationals. When the bearer of a valid U.S. passport applies for a new passport book and/or passport card with corrected personal data or when the bearer of a limited validity passport applies for a fully-valid replacement passport, the Department must confirm the applicant’s identity and eligibility to receive passport services before the Department can issue the corrected or replacement passport to the applicant. Form DS-5504 requests information that is necessary to determine whether the applicant is eligible to receive this service in accordance with the requirements of Title III of the Immigration and Nationality Act (INA) (U.S.C. sections 1402-1504), the regulations at 22 C.F.R. Parts 50 and 51, and other applicable authorities.
The information collected on the DS-5504 is used to facilitate the issuance of U.S. passports to U.S. citizens and nationals. The primary purpose for soliciting the information is to establish nationality, identity, and entitlement to the issuance of a U.S. passport, and to properly administer and enforce the laws pertaining to the issuance thereof.
The DS-5504 is retained in the files of the Department of State, along with other documentation related to passport applications, adjudication, and issuance. Among other uses, within the Department of State, these records are consulted when a U.S. passport has been lost and the bearer has no evidence of nationality available or in support of any derivative claims to nationality made by an applicant’s children. The records may also be consulted by consular personnel in the event of an emergency abroad involving Americans: the application has a block for the name, address, and telephone number of a person to notify in the event of an emergency. Information from the DS-5504 may also be shared with certain parties outside of the Department of State, as permitted by the Privacy Act of 1974, as amended, including as set forth in the Department of State’s Prefatory Statement of Routine Uses and the Department’s System of Records Notice (SORN) for Passport Records (STATE-26) and Overseas Citizens Services Records (STATE-05).
The DS-5504 becomes part of the applicant’s passport file, which is covered by the Privacy Act. The information contained in this file cannot be released except as provided by the Privacy and Freedom of Information Acts.
Intentionally making a false statement on the DS-5504 may constitute a violation of 18 U.S.C. sections 1001, 1542, and/or 1621.
The DS-5504 is currently available at http://www.travel.state.gov. However, the DS-5504 cannot be submitted electronically, because the U.S. Passport and additional documentary evidence (i.e., proof of name change) are required to be submitted in person or by mail with this form. The form can be filled out on-line and printed for manual signature and submission. When the application is complete, a 2-D barcode is printed on each form. This barcode is scanned by Passport Services and automatically records the applicant’s information in our system. This process saves both Passport Services and the applicant time and reduces errors.
Aside from necessary, basic self-identification data, the information requested does not duplicate information otherwise available. The DS-5504 is the sole Department of State form used by U.S. citizens and nationals who meet the qualifications to apply for a replacement passport.
This collection of information does not significantly impact small businesses or other small entities.
The information collected on the DS-5504 is crucial for documenting a U.S. citizen’s request for a replacement passport and for establishing the applicant’s entitlement to a replacement U.S. passport.
No such special circumstances exist.
The 60-day Federal Register Notice soliciting public comment was published on April 26, 2013 (78 FR 24782) and closed June 25, 2013. The Department of State received no comments on the 60-day notice in the Federal Register.
However, a 60-day public comment was received on the proposed DS-82, “U.S. Passport Renewal Application for Eligible Individuals” form regarding the wording in the Electronic Passport Statement. The commenter stated that he was confused about which type of passport to select when completing the form because the instructions refer to “a type of electronic passport book containing an embedded electronic chip and called an “Electronic Passport.” The Department replied with the following:
All passport books issued by the U.S. Department of State at this point in time are Electronic Passports Books that contain an embedded electronic chip. The Electronic Passport Statements in the Instructions sections in all public-use passport forms do not currently state this fact clearly.
As the result of this suggestion, the Department has revised the first sentence of the Electronic Passport Statement in the DS-82 as well as all other Public-Use Passport Forms from:
“The U.S. Department of State now issues a type of passport book containing an embedded electronic chip called an “Electronic Passport”
to read:
“The U.S. Department of State now issues an “Electronic Passport” book, which contains an embedded electronic chip.”
Therefore, this change has been made to the Electronic Passport Statement on page 4 of the DS-5504 form instructions.
This information collection does not provide any payment or gift to respondents.
This form includes a Privacy Act Statement explaining the routine uses of the information collected under the Act. There are no promises of confidentiality to the respondents other than those contained in federal statutes and regulations.
The DS-5504 collection of information asks the respondent to provide a Social Security number in order to confirm the applicant’s identity. Passport Services must confirm that the person applying for additional passport services is the same person to whom the U.S. passport was originally issued.
Passport Services estimates that the average time required for this information collection is 40 minutes per response. Therefore the estimated total annual burden for the collection is:
114,637 (number of
respondents) x 40 (minutes) / 60 = 76,425 hours per year
To estimate the cost to respondents for this form based on the hourly wage and weighted wage multiplier, the Department calculated the following:
$22.60 (mean hourly earnings based on estimated income per hour from the Bureau of Labor Statistics) x 1.4 (weighted wage multiplier) = $31.64 weighted wage
76,425 (annual hours) x $31.64 (weighted wage) = $2,418,087 hour burden cost
The estimated number of minutes required per response is based on a sampling of the time required to search existing data sources, gather the necessary information, provide the information required, review the final collection, and submit the collection to Passport Services for processing. The sampling was completed through consultation with a group of Consular Affairs employees to validate the time required. In addition, Passport Services has increased the estimated number of minutes per response from the previous 30 minutes to 40 minutes to allow for travel time for applicants to travel to their local United States Postal Service (USPS) facility to mail their application.
To properly complete and submit a DS-5504 passport application, an applicant must submit the following:
A certified copy of a marriage certificate or court order as specified in the instruction pages with a national average cost of $10.00. The estimated cost of the certified document was based on an internet search by various States.
A photograph that meets criteria specified in the instruction pages with a national average cost of $10.00. The estimated cost of a photograph is based on a sampling through consultation with a small group of actual respondents.
DS-5504 applications are submitted primarily by mail. Per information received from the United States Postal Service, the cost burden for postage is approximately $1.25 per application.
According to the Department, the overwhelming majority of respondents mail their DS-5504 application through their local USPS which is estimated to be an average distance of approximately 3 miles one way and 6 miles round trip. This distance is estimated to take an amount of five (5) minutes each way for a total of 10 minutes round trip.
Also, to determine the travel
cost to the respondent, the Department is factoring in the General
Services Administration (GSA) reimbursement rate of $0.56 mile for
privately owned automobiles (POA) use as of January 1, 2014.
(http://www.gsa.gov/portal/content/100715?utm_source=OGP&utm_medium=print-radio&utm_term=mileage&utm_campaign=shortcuts)
Therefore, the cost to the respondent to travel this
distance is estimated to be approximately $385,180.
114,637 (number of respondents) x 6 (miles) x $0.56 (miles) = $385,180.
When combining the individual estimated cost burdens associated with Form DS-5504, the total annual cost burden for approximately 114,637 applicants is $2,436,036. A complete breakdown of the involved costs to the respondent is outlined below.
114,637 – Certified copy of marriage certificate or court order (1) |
X |
$10.00 |
= |
$1,146,370 |
114,637 – Passport Photo |
X |
$10.00 |
= |
$1,146,370 |
114,637 – Postage Fee |
X |
$1.25 |
= |
$143,296 |
114,637 x 6 miles – Average Travel Cost |
X |
$ 0.56 |
= |
$385,180 |
Total Cost to Respondents |
|
|
= |
$2,821,216 |
The Department pays a contractor for materials and/or supplies purchase functions to produce the DS-5504. The estimate provided to the Department by the contractor includes cost for contractor labor, supplies, equipment, printing, materials, delivery, overhead, support staff, etc. Using the estimated projection of 114,637 respondents per year for FYs 2013 – 2016, at a cost of $35.00 per thousand, the contractor cost to the Federal Government is $4,025.
Also, the Department is providing the passport specialist time and salary cost which was derived using 2011 Time and Motion (T&M) Study numbers that measured processes conducted by passport specialists. This includes time spent to adjudicate (accept, review, and render a decision) specific forms. These average times were then used to calculate a weighted average of the number of respondents (application receipts) for each form, to account for differing amounts of time required to adjudicate a particular form. For forms that were not measured during the T&M study, no adjudication time multiplier was applied to the estimated number of respondents. The weighted averages were then converted into percentages and multiplied by the total estimated salary and total number of hours spent on adjudication tasks for passport specialists to arrive at the cost and time required to process each form. The total estimated salary is based on the existing ratio of grade levels at each passport agency and locality pay; the total number of hours is adjusted to reflect time spent only on adjudicative tasks.
Therefore, the DS-5504 passport specialist adjudication cost is calculated as follows:
2.2 (adjudication time multiplier) x 114,637 (respondents) / 21,765,378 (total weighted avg. of respondents, all passport forms) x $82,165,237 (total passport specialist salary) = $952,071
Or using numbers only,
[(2.2 x 114,637) / (21,765,378)] x ($82,165,237) = $952,071
With regard to the material costs (use of office supplies, printing, overhead, etc.) incurred by the passport specialist when adjudicating the DS-11, the Department has determined these costs to be negligible.
Therefore, the total cost to the Government is:
$4,025. (contractor) +$952,071. (passport specialist adjudication) = $956,096.
The projected adjustments indicated reflect a decrease in the number of projected respondents from 181,000 (previous 2010 – 2013) to 114,637 (FYs 2013-2016). The previous number of respondents was estimated based on a 2009 projection for those three years. However, using actual receipts for 2010 – 2012, the average total amounted to 94,395. Demand has decreased at a steady rate between 2010 through 2012. The annual number of respondents projected to use the DS-5504 for the next three years was adjusted to reflect the actual demand while taking into account a steady increase of all passport applications for Fiscal Years 2013 through 2016 (14,750,000 total). With the rise in overall passport applications, it is expected that name changes, data corrections, and limited passport book replacement will increase accordingly.
Demand forecast projections, by their nature, will have some uncertainty in their accuracy, which can explain differences between actual and forecast.
The change in respondent costs
is due to the elimination of the fees that were incorrectly
attributed as a Cost to Respondent in the last submission. The only
costs attributed to the respondent in this submission are for
passport photographs, certification of marriage certificate or court
order documents, and postage.
In addition to general format changes, the following content changes have been made to the form:
Page 1 Instructions – Under the heading “Can I Use This Form”, a new statement has been added at the bottom to read “My most recent, full-fee U.S. passport book was limited in validity due to a lost naturalization certificate or due to gender transition, and was issued less than two years ago.”
Page 3 Instructions – At the bottom of the page, a new section was added with the heading:
“Special Notice to U.S. Passport Card Applicants Only”
The section text follows:
“The maximum number of letters provided for your given name (first and middle) on the U.S. passport card is 24 characters. The 24 characters may be shortened due to printing restrictions. If both your given names are more than 24 characters, you must shorten one of your given names you list on item 1 of this form.”
Page 4 Instructions – Under the heading “Electronic Passport Statement”, the first sentence, “The U.S. Department of State now issues a type of passport book containing an embedded electronic chip called an “Electronic Passport.” has been revised to read “The U.S. Department of State now issues an “Electronic Passport” book, which contains an embedded electronic chip.”
Page 1 Form – In the photograph box, the words “Submit a recent color photograph” have been replaced with “Attach a color photograph taken within the last six months”.
Page 1 Form – In the first signature block, “Applicant’s Signature – age 16 and older”, the word “Legal” has been added before “Signature”.
Page 1 Form – The second signature block “Parent’s/Legal Guardian’s Signature” has been revised to now read “Mother/Father/Parent/Legal Guardian’s Signature (if identifying minor)”.
Page 2 Form – Line Item 19, Travel Plans: The words “Date of Trip” have been replaced with “Departure Date”, and the words “Duration of Trip” have been replaced with “Return Date”.
Page 2 Form – Under the
Yes and No blocks in the last section, the statement:
“If
yes, please submit evidence of your United States citizenship and/or
evidence of your identity.” was replaced by: “If yes,
please submit evidence of your United States citizenship (such as a
government birth certificate) and/or evidence of your identity (such
as a driver’s license or a state issued identification (ID)
card).”
The Department estimates that the above changes will not result in an increase in the revised burden time from 30 to 40 minutes, which was increased by 10 minutes for travel time as detailed under item 13.
Quantitative summaries of Department of State passport activities are published periodically on the Department of State website at www.travel.state.gov. Such summaries do not involve the use of complex analytical techniques.
The expiration date for OMB approval will be displayed.
The Department is not requesting any exceptions to the certification statement.
This collection does not employ statistical methods.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | SUPPORTING STATEMENT FOR |
| Author | USDOS |
| File Modified | 0000-00-00 |
| File Created | 2021-01-28 |