Information Collection

Affidavit of Parentage, Physical Presence and Support

IC 189229 under ICR 201510-1405-003 · OMB 1405-0187.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0187 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-5507 Affidavit of Parentage, Physical Presence and Support	Form and Instruction
DS-5507 AFFIDAVIT OF PHYSICAL PRESENCE OR RESIDENCE, PARENTAGE A DS5507 (9-18-2015).pdf www.state.gov/m/a/dir/forms/c21447.htm	Form and Instruction

IC Title:

Affidavit of Parentage, Physical Presence and Support

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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-5507	AFFIDAVIT OF PHYSICAL PRESENCE OR RESIDENCE, PARENTAGE AND SUPPORT	DS5507 (9-18-2015).pdf	http://www.state.gov/m/a/dir/forms/c21447.htm	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17,716

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	Previously Approved
Annual Number of Responses for this IC	17,716	-68	17,784
Annual IC Time Burden (Hours)	8,858	-34	8,892
Annual IC Cost Burden (Dollars)	361,566	361,566	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.