Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-3053 Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	Form and Instruction	Modified	Available
DS-3053_30day_2019_LegalAuthorities_FINAL.docx	Supplementary Document	Uploaded 2019-08-27	Available
Final - DS-3053_30day_2019_SuppStmt.docx	Supporting Statement A	Uploaded 2020-11-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
14999	Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0129	ICR Reference No: 201908-1405-005
Status: Active	Previous ICR Reference No: 201607-1405-003
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16
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: 12/15/2020
	Date Received in OIRA: 08/27/2019
Terms of Clearance: The agency revised its supporting statement to further clarify the burden to 16 and 17 year-olds associated with the collection. It also made revisions to the instructions on the form to better reflect the applicability of the form to 16 and 17 year-olds. The agency is instructed that any ALDACs associated with communicating changes associated with this or related OMB Control Nos. should be provided to OIRA for review in advance of circulation

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved	12/31/2020
Responses	416,477	0	465,848
Time Burden (Hours)	138,826	0	155,127
Cost Burden (Dollars)	2,136,527	0	1,164,620

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Abstract: The information collected on the DS-3053 is used to facilitate the issuance of passports to U.S. citizens and nationals under the age of 16. The primary purpose of soliciting the information is to ensure that both parents and/or all guardians consent to the issuance of a passport to a minor under the age 16, except where one parent has sole custody or there are exigent or special family circumstances.

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Authorizing Statute(s): US Code: 22 USC 6039E Name of Law: Information concerning resident status
   US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
   US Code: 8 USC 1104 Name of Law: Powers and duties of Secretary of State
   US Code: 18 USC 1542-1544 Name of Law: False statement in application and use of passport
   PL: Pub.L. 106 - 113 Section 1000 (a)(7)), Name of Law: Foreign Relations Authorization Act, Fiscal Year 2000 and 2001
  

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 27390	06/12/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 44962	08/27/2019
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	DS-3053	Statment of Consent: Issuance of a US Passport to a Minor Under Age 16

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ICR Summary of Burden

table that charts list 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	416,477	465,848	0	-49,371	0	0
Annual Time Burden (Hours)	138,826	155,127	0	-16,301	0	0
Annual Cost Burden (Dollars)	2,136,527	1,164,620	0	971,907	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: Miscellaneous Actions

Short Statement: The decline from the previous estimates (465,848 respondents to 416,478) reflects two countervailing changes. First, the Department of State (the Department) projects fewer applicants under the age of 16 are using the form, accounting for the overall decline. However, the Department is also now incorporating calculations related to the limited subset of 16-17 year old passport applicants who may be required to submit a completed, notarized DS-3053 as part of their passport application. As discussed previously in this supporting statement, in most cases passport authorizing officials receiving passport applications from 16-17 year olds are able to ascertain parental awareness of the application without requiring a completed, notarized DS-3053.However, the Department acknowledges that in order to more accurately reflect the respondents to this form, the Department decided to add this group in for the FY2019-2021 timeframe.

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Annual Cost to Federal Government: $324,799

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

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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: 08/27/2019

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