Final SS

SUPPORTING STATEMENT

FOR PAPERWORK REDUCTION ACT SUBMISSION

Statement of Consent: Issuance of a U.S. Passport to

a Minor under Age 16

OMB Number 1405-0129

DS-3053

A. JUSTIFICATION

1. The Statement of Consent: Issuance of a U.S. Passport to a Minor under Age 16 (DS-3053) is used in conjunction with the Application for a U.S. Passport (DS-11). This form is used only in cases when both parents and/or legal guardian(s) of a child under age 16 cannot be present at the time the application is executed. The form is completed by the non-applying parent or guardian to give his or her statutorily required consent to the issuance of a passport to the minor or by the appearing parent or guardian to explain the absence of the non-appearing parent’s or guardian’s consent.

The DS-3053 form assists the Department of State to administer the regulations in 22 C.F.R. 51.28 requiring that both parents and/or any guardian consent to the issuance of a passport to a minor under age 16, unless certain exceptions apply. This regulation was mandated by Section 236 of the Admiral James W. Nance and Meg Donovan Foreign Relations authorization Act, Fiscal Year 2000 and 2001 (enacted by Public Law 106-113, Div. B, Section 1000 (a)(7)), and helps to prevent international parental child abduction, as well as child trafficking and other forms of passport fraud.

2. Form DS-3053 is used by Passport Services to assist in determining that both parents and/or legal guardian(s) have given consent to the issuance of a U.S. passport to a minor under age 16.

3. The DS-3053 is intended to be submitted with the DS-11, which cannot be submitted electronically. As required by 22 C.F.R. Part 51, all DS-11 applicants (and applicants under 16) must appear in person for the execution of a passport.  In addition, the DS-3053 requires a notarization statement and notary signature, as well as the non-applying parent or guardian’s signature in the presence of the notary public. The DS-3053 is on the Department’s website www.travel.state.gov where it can be filled out on-line and printed for manual signature, notarization, and submission.

3. Aside from necessary basic self-identification data, the information requested does not duplicate information otherwise available.

3. The DS-3053 does not involve small businesses or other small entities.

3. The DS-3053, “Statement of Consent: Issuance of a U.S. Passport to a Minor under Age 16” is used in conjunction with the “Application for a U.S. Passport” (DS-11). When a minor under the age of 16 applies for a passport and one of the minor’s parents or legal guardians is unavailable at the time the passport application is executed, a completed and notarized DS-3053 can be used as the statement of consent. If the required statement is not submitted, the minor shall not receive a U.S. passport. The required statement may be submitted in other formats provided they meet statutory and regulatory requirements. Use of the DS-3053 is not mandatory.

3. No such special circumstances exist.

3. The Department of State published a 60-day notice in the Federal Register to solicit public comments on March 30, 2016 (81 FR 17754). No comments were received.

3. This information collection does not provide any payment or gift to respondents.

3. This form includes a Privacy Act Statement explaining the routine uses of the information collected under the Act. No assurances of confidentiality are provided to respondents.

3. The DS-3053 does not ask questions of a sensitive nature.

3. Passport Services estimates that the average time required for this information collection, including the collection of resources and travel time, is 20 (minutes) or 0.333 (hour) per response. Therefore, the estimated total annual burden for the collection is:

465,848 (number of respondents) x 0.333 (hour) = 155,127 hours per year.

The estimated number of minutes per response is based on a sampling of the time required to search existing data sources, gather the necessary information, provide the information required, have the form notarized, review the final collection, and submit the collection to Passport Services for processing.

To estimate the cost to respondents for this form based on the hourly wage and weighted wage multiplier, the Department calculated the following:

$22.71 (mean hourly earnings based on estimated income per hour from the Bureau of Labor Statistics) x 1.4 (weighted wage multiplier) = $31.79 weighted wage

155,127 (hour burden) x $31.79 (weighted wage) = $4,931,487 (hour burden cost)

3. There is no application fee associated with this collection. Form DS-3053 is submitted in conjunction with form DS-11, Application for a U.S. Passport. However, because the form must be notarized, customers may be required to pay a notarization fee. The national average cost to have a document notarized is $5.00. Since some respondents are expected to have access to cost-free notary services, we have calculated that 50% of respondents will incur a notarization fee.

Therefore, the total estimated cost burden to respondents is $1,164,620. (465,848 respondents x $5.00 average fee x 0.50 probability of incurring a fee).

3. The DS-3053 will be produced by a contractor with cost-plus-fixed-fee line items for materials and/or supplies purchase functions. The estimate provided to the Department by the contractor includes costs for contractor labor, supplies, equipment, printing materials, delivery, overhead, support staff, etc. Based on the projected number of 465,848 respondents (which will be rounded up to 466,000) per year for the next three years, at a cost of $35.00 per thousand, the contractor printing cost to the Federal Government is $16,310.

During Passport Services’ review of production standards in 2015, the Office of Adjudication conducted a “frequency analysis” to determine, among other things, how long it takes to process certain applications and how often certain forms were submitted, as current technology does not keep track of this information.  Analysts went into the field, and counted approximately 39,229 DS-11 applications to obtain a statistically significant sample of the workload.  The sample showed that approximately 3.96% of all DS-11 applications were accompanied by form DS-3053 that included the non-appearing parent/guardian’s consent.  Therefore, based on a projected workload of 11,763,831 DS-11 applications per year over the next three years, the Department estimates that approximately 465,848 applications per year would be accompanied by a DS-3053.

Based on the Office of Adjudication’s observations, the average processing time for a DS-3053 is 0.5 minutes. The Department’s Bureau of Budget and Planning places the hourly wage of a domestic Civil Service employee over the span of FY 2015, FY 2016, and FY 2017 at $67.12/hr.

$67.12/120 = $0.56 per DS-3053

$0.56 * 465,848 respondents = $260,875 labor costs

Combining the $260,875 labor costs with the $16,310 contractor printing cost yields annualized total Federal government cost of $277,185.

3. Demand forecast projections, by their nature, will have some uncertainty in their accuracy, which can explain differences between actual and forecast.

However, the decrease from the previous burden estimates (556,075 respondents to 465,848 and $1,390,188 in cost burden to respondents to $1,164,620) may be attributed to splitting the one form into two. The DS-5525, Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor under Age 16, was introduced in the last three year cycle and the Department is still adjusting its impact on forecasts and workload.

In addition to general format changes, the following content changes have been made to the form:

• Information on “Special Requirements for Institutions and Entities Granted Guardianship” were added to the form.

• The non-applying parent/guardian must now specify by name the person he/she is authorizing to apply for the minor’s passport in order to assist with in loco parentis cases.

3. Quantitative summaries of Department of State passport activities are published periodically on the Department of State website at: http://www.travel.state.gov/. Such summaries do not involve the use of complex analytical techniques.

3. The expiration date for OMB approval will be displayed.

3. The Department is not requesting any exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

This collection does not employ statistical methods.