Supplemental Questionnaire to Determine Identity for a U.S. Passport

Forms and Documents

Document Name	Status
Form DS-5520 Supplemental Questionnaire to Determine Identity for a U.S. Passport Form and Instruction	Modified
DS-5520_30day_2019_Legal Authorities.docx Supplementary Document	2019-08-27
DS-5520_30day_2019_SuppStmt_FINAL.docx Supporting Statement A	2019-08-27

IC Document Collections

IC ID	Document Title	Status
203622	Supplemental Questionnaire to Determine Identity for a U.S. Passport Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0215	ICR Reference No: 201908-1405-003
Status: Received in OIRA	Previous ICR Reference No: 201607-1405-006
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Supplemental Questionnaire to Determine Identity for a U.S. Passport
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/27/2019

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	21,891	82,347
Time Burden (Hours)	16,418	61,760
Cost Burden (Dollars)	0	0

---

Abstract: The primary purpose for soliciting this information is to validate an identity claim for a U.S. Passport book or passport Card in the narrow category of cases in which the evidence presented by an applicant is insufficient to establish identity. The information may also be used in adjudicating application or other travel documents and services, and in connection with law enforcement, fraud prevention, border security, counter terrorism, litigation activities, and administrative purposes.

---

Authorizing Statute(s): US Code: 8 USC 1201-1503 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 27681	06/13/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 44961	08/27/2019
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
Supplemental Questionnaire to Determine Identity for a U.S. Passport	DS-5520	SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U.S. PASSPORT

---

ICR Summary of Burden

	Total Request	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	21,891	82,347	0	-60,456	0	0
Annual Time Burden (Hours)	16,418	61,760	0	-45,342	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: The program reflects a steep decrease in respondent’s use of this form from 82,347 to 21,891. This can be attributed to better and increased usage of backend databases that specialists use to verify an applicant’s identity, eliminating the need, in most cases, to send the particular IRLs that would include the DS-5520.

---

Annual Cost to Federal Government: $27,749

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.     Yes

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

---

Common Form ICR:  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:

(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: 08/27/2019

---