Affidavit of Identifying Witness

Forms and Documents

Document Name	Status
Form DS-0071 Affidavit of Identifying Witness Form and Instruction	Modified
DS-71_legal_Authorities.doc Supplementary Document	2016-02-22
DIR Review - Supstmnte DS-71_2015FINAL.docx Supporting Statement A	2016-02-22

IC Document Collections

IC ID	Document Title	Status
14904	Affidavit of Identifying Witness Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0088	ICR Reference No: 201602-1405-013
Status: Historical Active	Previous ICR Reference No: 201202-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Affidavit of Identifying Witness
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/30/2016
	Date Received in OIRA: 02/22/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved	07/31/2016
Responses	61,000	0	44,000
Time Burden (Hours)	5,083	0	3,667
Cost Burden (Dollars)	0	0	0

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Abstract: The Affidavit of identifying witness is submitted in conjunction with a application for a U.S. passport. It is used by Passport Services to collect information for the purpose of establishing the identify of the applicant.This application is completed by the identifying witness when the applicant is unable to establish his or her identity to the satisfaction of a person authorized to accept passport applications.

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Authorizing Statute(s): EO: EO 11295 Name/Subject of EO: Rules governing the granting, issuing, and verifying of United States passports Rules govern
   US Code: 22 USC 211 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:
	80 FR 69270	11/09/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 8586	02/19/2016
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Affidavit of Identifying Witness	DS-0071	AFFIDAVIT OF IDENTIFYING WITNESS

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ICR Summary 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	61,000	44,000	0	17,000	0	0
Annual Time Burden (Hours)	5,083	3,667	0	1,416	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The program change reflects an increase in respondents’ use of this form from 44,000 to 61,000. This increase is based on the expectation that passport demand in general will greatly increase over the next few years, impacting all form projections, including the DS-71. Changes in costs reported in sections 12 and 14 are due to using different cost and time estimates that now conform to methods used elsewhere in the Department of State, in particular, using information on recurring costs from the Bureau of Budget and Planning’s New Position Cost model.

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Annual Cost to Federal Government: $68,320

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: 02/22/2016

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