DS-5513_30day SuppStmt_2019_FINAL

SUPPORTING STATEMENT FOR
PAPERWORK REDUCTION ACT SUBMISSION

Supplemental Questionnaire to Determine Entitlement for
a U.S. Passport
OMB Number 1405-0214
DS-5513

A. JUSTIFICATION

1. Why is this collection necessary and what are the legal statutes that allow this?

The Supplemental Questionnaire to Determine Entitlement for a U.S. Passport, form DS-5513, is used to supplement an application for a U.S. passport when the applicant submits entitlement evidence that is insufficient or of questionable authenticity. Passport Specialists and Consular Officers will use this form to collect additional information to further establish an applicant’s entitlement to a U.S. passport when the applicant has not submitted adequate evidence with his/her initial passport application.

The DS-5513 solicits data necessary for Passport Services to issue a United States passport in the exercise of responsibilities granted to the Secretary of State in 22 U.S.C. 211a and Executive Order 11295 (August 5, 1966) for the issuance of passports to U.S. citizens and noncitizen nationals. Such responsibilities require the determination of identity and citizenship or nationality with reference to the provisions of Title III of the Immigration and Nationality Act (8 U.S.C. sections 1401 – 1504) and the 14th Amendment to the Constitution of the United States, and compliance with 22 U.S.C. 212 and 213. Implementing regulations are found at 22 C.F.R. parts 50 and 51.

By definition, a passport is a travel document issued under the authority of the Secretary of State attesting to the identity and nationality of the bearer (22 C.F.R. 51.1 (d)). An applicant bears the burden of establishing his or her identity and entitlement, and the Department may require an applicant to submit such additional evidence of identity or entitlement as it deems to be necessary (22 C.F.R. §§ 51.23, 51.40, 51.45). The procedures for establishing an applicant’s identity and entitlement are outlined in 22 C.F.R. part 51, subparts B and C.

The legal authorities under which the information is requested include, but are not limited to the following:

22 U.S.C. § 211a et seq.;

22 U.S.C. 2714a(f);

26 U.S.C. 6039E

Executive Order 11295;

22 C.F.R. Parts 50 and 51

2. What business purpose is the information gathered going to be used for?

The Department of State uses this information to verify the respondent’s entitlement to a U.S. passport. The information is also used to combat passport fraud and misuse. This form is used to supplement an existing passport application and solicits information relating to the respondent’s family and birth circumstances that is needed prior to passport issuance. Without adequate information about an applicant, the Department cannot issue that applicant a U.S. passport. Furthermore, inaccurate evidence or information could possibly result in issuance of a passport to a non-U.S. citizen or to an individual using an assumed identity. In addition to this primary use of the data, the DS-5513 may also be used as evidence in the prosecution of any individual who makes a false statement on his/her application for a U.S. passport, and for other uses as set forth in the Department wide Prefatory Statement of Routine Uses, Passport Services System of Records Notice (State-26), and the System of Records Notice for Overseas Citizens Services Records and Other Overseas Records (State-05) .

3. Is this collection able to be completed electronically (e.g. through a website or application)?

The DS-5513 is issued by the Department of State. If the information on the DS-5513 is needed, the passport agency mails the form directly to the applicant for completion and return. Due to its potential role in combatting fraud and misuse, this form cannot be found online at travel.state.gov, nor can it be obtained at acceptance facilities.

4. Does this collection duplicate any other collection of information?

The information collected does not duplicate information collected elsewhere.

5. Describe any impacts on small business.

The collection of information does not involve small businesses or other small entities.

6. What are consequences if this collection is not done?

The information cannot be collected less frequently. It must be collected to issue a passport, document, or render a service. Eliminating the Department of State’s ability to solicit vital entitlement information from knowledgeable sources in connection with passport services could result in unnecessary passport denials or issuance of passports to ineligible persons.

7. Are there any special collection circumstances?

No such special circumstances exist.

8. Document publication (or intent to publish) a request for public comments in the Federal Register

One June 14, 2019, the Department of State published a 60-day notice in the Federal Register, 84 FR 27828, to solicit public comments. No comments were received on www.regulations.gov and no comments were received through email at [email protected].

9. Are payments or gifts given to the respondents?

This information collection does not provide any payment or gift to respondents.

10. Describe assurances of privacy/confidentiality

The form includes a Privacy Act Statement explaining the routine use exceptions to the Act. (5 U.S.C. § 552a). No promises of confidentiality are made to respondents. Passport applicants are required to submit their Social Security numbers with the passport application and failure to provide a Social Security number may result in the denial of an application (consistent with 22 U.S.C. 2714a(f)).

11. Are any questions of a sensitive nature asked?

The DS-5513 does not ask questions of a sensitive nature.

12. Describe the hour time burden and the hour cost burden on the respondent needed to complete this collection

The estimated burden of 85 minutes required per response is based on a sampling of time required to complete this form.

To calculate the estimated number of respondents over the next three years, we take the average of the last three years and determine what percentage of DS-11, Application for a U.S. Passport, would use the DS-5513. (The DS-5513 is usually associated with the DS-11.)

Average # of DS-5513 Respondents over Last Three Years
1

Fiscal Year	Number of respondents
2016	3,820
2017	3,998
2018	3,830
AVERAGE	3,883

Average # of DS-11 Respondents over Last Three Years

Fiscal Year	Number of respondents
2016	9,846,900
2017	10,726,416
2018	10,726,532
AVERAGE	10,433,283

We find that 3,883 is 0.037% of 10,433,283. So to get the projected number of DS-5513 respondents over the next three years, we calculate 0.037% of the projected average annual DS-11 respondents:

Projected DS-11 Respondents over Next Three Years

Fiscal Year	Number of respondents
2019	10,600,000
2020	11,200,000
2021	11,245,000
AVERAGE	11,015,000

The projected number of DS-5513 respondents is 4,076 per year. (11,015,000 x 0.00037 = 4,076, rounded)

The annual burden is estimated to be 5,774 hours. (4,076 X 85 minutes / 60).

The estimated cost to respondents is based on the civilian hourly wage from the Bureau of Labor Statistics website multiplied by the annual time burden (5,774 hours). The average wage is estimated to be $25.22. This form can be used by anyone and therefore we are unable to further specify the group. The Department used the Employer Costs for Employee Compensation released by the Bureau of Labor Statistics in 2019.ⁱ

Therefore the estimated annual hour burden cost to respondents is: 5,774 (hour burden) x $25.22 (average wage) = $145,620.28.

13. Describe the monetary burden to respondents (out of pocket costs) needed to complete this collection.

There is no application cost to respondents associated with this form.

14. Describe the cost incurred by the Federal Government to complete this collection.

To calculate the cost to the Federal Government, we take into account the hourly wage for a FY 2019 domestic Civil Service GS-11 step 10 (the highest level of a passport adjudicator), which is $33.52ⁱⁱ. Passport Services estimates that reviewing the DS-5513 requires 21 minutes of a passport adjudicator’s time. Dividing $33.52/hr. by 60 minutes yields a processing time cost of $0.56 per minute, multiplied by 21 minutes is $11.76. Multiplying the projected number of annual respondents (4,076) by $11.76 yields $47,933.76 a year. This number is added to the cost to the Federal Government to print the forms and publish the Federal Register Notices (FRNs).

The estimated amount to publish one Federal Register Notice (FRN) is $795ⁱⁱⁱ. A 60-day FRN and a 30-day FRN is published for each form with a total cost to the Federal Government of $1,590.

The DS-5513 is not available online or at acceptance facilities. It is only available in hard copy from Department of State facilities. When a passport agency requires this information, it mails a physical copy of the form to the applicant. The cost of printing these forms in-house (they are not printed in bulk like other passport forms) is estimated to be about $0.025 per page, so $0.10 per form DS-5513. Multiplying the projected number of respondents (4,076) by $0.10 yields $407.60 a year.

Cost to Federal Government

Adjudication cost	4,076 x $11.76 =	$ 47,933.76
Printing cost	4,076 x $0.10 =	$ 407.60
Federal Register Notice	2 x $795 =	$1,590.00
TOTAL		$ 49,931.36

15. Explain any changes/adjustments to this collection since the previous submission

The program change reflects an increase in respondents’ use of this form from 3,257 to 4,076. This is likely due to the increase in number of DS-11s over the last three years.

In addition to format and instructional clarification based on field feedback on the form, the following changes were made:

Page 1, first section

- Changed “USE OF SUPPLEMENTAL QUESTIONNAIRE TO ESTABLISH ENTITLEMENT FOR A U.S. PASSPORT” to “USE OF THIS FORM”

- Added “citizenship” to "…you may be asked to provide further documentary evidence to support your citizenship claim."

- Changed web address to travel.state.gov/citizenship

- Added “page 1” to “please page two of the instructions for the DS-11...”

Page 1, second section

- Changed “FORM INSTRUCTIONS” to “IMPORTANT”

- Deleted Question #5 (recommendation of working groups and subject matter experts)

- Reworded #3 and moved to #1, emphasized – “All questions must be answered to the best of your knowledge.”

- Changed #2 to read: “Please submit the information and/or documentation requested with this supplemental questionnaire to the requesting passport office.”

- Changed web address to travel.state.gov/citizenship

- Moved #3 to the top

- Deleted “If you are unsure of the answer to a question, please provide a response to the best of your knowledge.”

Page 1, third section

- Added “TTY” after “TDD”

- Deleted “Customer Service Representatives are available Monday-Friday, 8:00 a.m.-10:00 p.m. Eastern Time (excluding federal holidays). Automated information is available 24/7.”

Page 1, fourth section

- Warning reworded to be consistent with DS-11

Page 1, fifth section

- AUTHORITIES: Changed “We are authorized to collect this information by 22 U.S.C…” to read “Collection of this information is authorized by 22 U.S.C...”

- Added 26 U.S.C. 6039E

- Added "and Other Overseas Records" to State-05

- Reworded “Disclosure” section

Page 1, sixth section

- Changed contact office and office address

Page 2, Section B

- Changed title of section to just "Family (Living or Deceased)"

- Changed "City, State/Country" to "U.S. City & State or City & Country" for consistency

- Deleted the row with “Example” in each of the five columns.

- Added "Include maiden name, if applicable" under the "Full Name" column.

- Added statement: Attach a separate sheet, if needed

- Changed “Parent(s)” example to “Brother”

- Changed “Sibling(s)” to “Sister(s)/Brother(s)” in the first column

- Changed “Provide any other names your relatives above may have used.” to “List name changes for any of your relatives above. For example, “Mother’s maiden name – Jane Johnson”

Page 2, Section C

- Changed "City, State/Country" to "U.S. City & State or City & Country" for consistency

- Shorten the space for question “Please provide the names of persons present at your birth.”

- Added (s) to “Parents’ place(s) of employment at the time of your birth”

- Change "doctor" to "medical professional"

Page 3, Question 3

- Included “(attach a separate sheet, if needed)” since the form provides only two lines for residences and parents of applicants may have had more than two.

- Added (s) to “Parents’ place(s) of employment at the time of your birth”

Page 3, Question 4

- Start the question with “List your” to be consistent with Question 3.

Page 4, Section C

- Deleted #5. IRL 876-01 requests records; section is duplicative, is not completed by applicant.

Page 4, Section D and E

- Deleted the row with “Example” in each of the five columns.

Page 4, Section D

- Changed to read - “Please list any schools, day care centers, or developmental programs you attended from birth to age 18, in or outside the United States, starting with the first three you attended”.

- Added two rows for additional schools

Page 4, Section E

- Changed to read - “Please list all of your residences, inside and outside the United States, from birth to age 18, starting with your first three.

- Added two rows for additional residences

Page 4, Section F

- Changed "responses contained" to "statements made" to be consistent with other forms

All

- Changed “Passport Services” to “Department”

16. Specify if the data gathered by this collection will be published.

The collection of information is not planned to be published for statistical use.

17. If applicable, explain the reason(s) for seeking approval to not display the OMB expiration date.

The expiration date for OMB approval will be displayed.

18. Explain any exceptions to the OMB certification statement below.

The Department is not seeking exceptions to the certification statement.

B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS

This collection does not employ statistical methods.

i Source: Bureau of Labor Statistics, “Employer Costs for Employee Compensation – December 2018,” https://www.bls.gov/news.release/ecec.toc.htm.

ii Source: Office of Personnel Management, “2019 General Schedule (GS) Locality Pay Tables,” https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/19Tables/html/GS_h.aspx

iiiSource: Government Printing Office, “Circular Letter No. 1003, March 28, 2018,”

https://www.gpo.gov/how-to-work-with-us/agency/circular-letters/new-federal-register-publishing-rates

Unclassified