Courier Drop-Off List for U.S. Passport Applications

Forms and Documents

Document Name	Status
Form DS-4283 Courier Drop-Off List for U.S. Passport Applications Form and Instruction	Modified
Final - DS-4283 Supporting Statement 7-7-20.docx Supporting Statement A	2020-07-07
Legal_Authorities_DS-4283.doc Supplementary Document	2019-05-03

IC Document Collections

IC ID	Document Title	Status
220054	Courier Drop-Off List for U.S. Passport Applications Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0222	ICR Reference No: 201905-1405-003
Status: Active	Previous ICR Reference No: 201604-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Courier Drop-Off List for U.S. Passport Applications
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/07/2020
	Date Received in OIRA: 05/03/2019
Terms of Clearance: DS-4283 is now PDF fillable except for the signature field. Minor adjustments made to the Supporting Statement. Four months prior to resubmission of this collection, the agency will consult with OIRA regarding adopting a capacity for accepting electronic signature.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2022	36 Months From Approved	07/31/2020
Responses	238,554	0	216,000
Time Burden (Hours)	39,759	0	36,000
Cost Burden (Dollars)	52,482	0	47,520

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Abstract: The information collected on the DS-4283 is used to facilitate the issuance of passports to U.S. nationals with imminent travel plans who hire private courier companies to deliver their applications to one of the Department’s domestic passport agencies. The Department asks courier company employees to complete the DS-4283 and submit the form with passport applications delivered in bulk to passport agencies in a designated drop-off box. Passport agencies use the form to track the submission of applications that a courier drops off. The form serves as a record of receipt of documents submitted to the Department and as an acknowledgment of who delivered these documents. The DS-4283 is part of a Department effort to facilitate the delivery of passport applications by private courier companies while maintaining the integrity of the passport application process.

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Authorizing Statute(s): US Code: 22 USC 2670 Name of Law: Authority to Establish, Maintain and Operate Passport Agencies
   US Code: 22 USC 211a 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:
	84 FR 1528	02/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 18332	04/30/2019
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Courier Drop-Off List for U.S. Passport Applications	DS-4283	Courier Drop-Off List for U.S. Passport Applications

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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	238,554	216,000	0	22,554	0	0
Annual Time Burden (Hours)	39,759	36,000	0	3,759	0	0
Annual Cost Burden (Dollars)	52,482	47,520	0	4,962	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 burden hours from 36,000 in 2015 to 39,759. This increase is based on the fact that the number of responses has also increased, from 216,000 to 238,554.This increase correlates to the overall increase in passport demand over the last few years, with the number of applications received at the public counter increasing from 840,732 in 2015 to 907,495 in 2018

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 05/03/2019

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