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Supplemental Questionnaire to Determine Identity for a U.S. Passport
Updated - Supplemental Questionnaire to Determine Identity for a U.S. Passport
OMB: 1405-0215
IC ID: 203622
OMB.report
STATE/AFA
OMB 1405-0215
ICR 201908-1405-003
IC 203622
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0215 can be found here:
2024-03-12 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form DS-5520
Supplemental Questionnaire to Determine Identity for a U.S. Passport
Form and Instruction
DS-5520 SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U
DS-5520_30day_2019_Form (PDF)_FINAL.pdf
www.travel.state.gov
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Supplemental Questionnaire to Determine Identity for 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 51.23,40,45
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
DS-5520
SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U.S. PASSPORT
DS-5520_30day_2019_Form (PDF)_FINAL.pdf
www.travel.state.gov
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Homeland Security
Subfunction:
Border and Transportation Security
Privacy Act System of Records
Title:
Passport Records, STATE-26
FR Citation:
81 FR 19863
Number of Respondents:
21,891
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
21,891
0
-60,456
0
0
82,347
Annual IC Time Burden (Hours)
16,418
0
-45,342
0
0
61,760
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.