Application for Replacement Naturalization/Citizenship Document

ICR 201805-1615-004

OMB: 1615-0091

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2018-05-03
Justification for No Material/Nonsubstantive Change
2018-05-02
IC Document Collections
ICR Details
1615-0091 201805-1615-004
Historical Active 201705-1615-006
DHS/USCIS N-565
Application for Replacement Naturalization/Citizenship Document
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/10/2018
Retrieve Notice of Action (NOA) 05/04/2018
  Inventory as of this Action Requested Previously Approved
06/30/2019 06/30/2019 06/30/2019
27,954 0 27,954
25,606 0 25,606
3,424,365 0 3,424,365

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

  82 FR 11477 02/23/2017
82 FR 22014 05/11/2017
Yes

  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 27,954 27,954 0 0 0 0
Annual Time Burden (Hours) 25,606 25,606 0 0 0 0
Annual Cost Burden (Dollars) 3,424,365 3,424,365 0 0 0 0
No
No

$15,514,470
No
    Yes
    Yes
No
No
No
Uncollected
Kerstin Jager 214 489-8022 [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.
05/04/2018


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