Application for Replacement Naturalization/Citizenship Document

ICR 201610-1615-036

OMB: 1615-0091

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2016-10-25
Supplementary Document
2016-10-24
Justification for No Material/Nonsubstantive Change
2016-10-27
Supplementary Document
2016-10-25
IC Document Collections
ICR Details
1615-0091 201610-1615-036
Historical Active 201606-1615-001
DHS/USCIS N-565
Application for Replacement Naturalization/Citizenship Document
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 10/31/2016
Retrieve Notice of Action (NOA) 10/28/2016
Previous terms of clearance continue to apply. USCIS may continue to use the previous version of the instrument until December 23, 2016.
  Inventory as of this Action Requested Previously Approved
05/31/2017 05/31/2017 05/31/2017
29,298 0 29,298
26,836 0 26,836
3,589,005 0 3,589,005

This form is used by USCIS to determine an applicant's eligibility for a replacement document that was lost, mutilated or destroyed, or if the applicant's name was changed by marriage or by court order after the original document was issued. Additionally, this form is used by a naturalized citizen applicant who desires to obtain a special certificate of recognition as a citizen of the United States by a foreign country.

US Code: 8 USC 1454 Name of Law: U.S. Code
  
None

Not associated with rulemaking

  79 FR 64612 10/30/2014
80 FR 9742 02/24/2015
Yes

1
IC Title Form No. Form Name
Application for Replacement Naturalization/Citizenship Document N-565 Application for Replacement Naturalization/Citizenship Document

  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 29,298 29,298 0 0 0 0
Annual Time Burden (Hours) 26,836 26,836 0 0 0 0
Annual Cost Burden (Dollars) 3,589,005 3,589,005 0 0 0 0
No
No

$10,107,810
No
No
No
No
No
Uncollected
John Ramsay 202 646-4247 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/28/2016


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