Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement

Forms and Documents

Document Name	Status
Form DS-5504 Application for a U.S. Passport: Name Change, Data Corrections, and Limited Passport Book Replacement Form and Instruction	Modified
Final DS-5504_60day_2019_LegalAuthorities.docx Supplementary Document	2019-10-25
Final DS-5504_30day_2019_Supp Stmt.docx Supporting Statement A	2019-10-25

IC Document Collections

IC ID	Document Title	Status
15051	Application for a U.S. Passport: Name Change, Data Corrections, and Limited Passport Book Replacement Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0160	ICR Reference No: 201910-1405-004
Status: Historical Active	Previous ICR Reference No: 201609-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/25/2019
	Date Received in OIRA: 10/25/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	11/30/2019
Responses	138,000	0	136,833
Time Burden (Hours)	92,000	0	91,222
Cost Burden (Dollars)	3,564,540	0	1,982,710

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Abstract: The Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement (DS-5504) is the form used by current passport holders who need to re-apply for a new passport within one year of the date of issuance for the following conditions: a) the passport holder's name has changed within the first year of the issuance of the passport; b) the passport holder needs correction of descriptive information on the data page of the passport; c) the passport holder wishes to obtain a fully valid passport after obtaining a full-fee passport with a limited validity of two years or less.

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Authorizing Statute(s): 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 37707	08/01/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 57546	10/25/2019
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Application for a U.S. Passport: Name Change, Data Corrections, and Limited Passport Book Replacement	DS-5504	APPLICATION FOR A U.S. PASSPORT CORRECTIONS, NAME CHANGE WITHIN 1 YEAR OF PASSPORT ISSUANCE, AND LIMITED PASSPORT HOLDERS

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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	138,000	136,833	0	1,167	0	0
Annual Time Burden (Hours)	92,000	91,222	0	778	0	0
Annual Cost Burden (Dollars)	3,564,540	1,982,710	0	1,581,830	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 adjustments reflect a slight increase in the number of projected respondents from 136,833 (FYs 2016-2018) to 138,000 (FYs 2019-2021). The demand has leveled off in the last couple years after the surge in demand around 2017 and 2018. Using the actual historical application count for FY 2016-2018, the average total DS-5504 receipts amounted to 125,145 per year. Demand forecast projections, by their nature, will have some uncertainty in their accuracy, which can explain differences between actual and forecast.

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Annual Cost to Federal Government: $377,295

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? Uncollected

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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: 10/25/2019

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