Information Collection

Statement of Non-Receipt of a U.S. Passport

IC 15031 under ICR 201709-1405-004 · OMB 1405-0146.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0146 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-86 Statement of Non-Receipt of a U.S. Passport	Form and Instruction
DS-86 Statement of Non-Receipt of a U.S. Passport DS-0086 Form Draft.pdf www.travel.state.gov	Form and Instruction

IC Title:

Statement of Non-Receipt of a U.S. Passport

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 51.2(b)

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-86	Statement of Non-Receipt of a U.S. Passport	DS-0086 Form Draft.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15,330

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	15,330	325	15,005
Annual IC Time Burden (Hours)	3,833	82	3,751
Annual IC Cost Burden (Dollars)	3,372	71	3,301

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.