Information Collection

Application for Replacement Naturalization/Citizenship Document - Electronic

IC 239294 under ICR 202001-1615-005 · OMB 1615-0091.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0091 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form N-565 Application for Replacement Naturalization/Citizenship Document - Electronic	Form and Instruction
N-565 Application for Replacement Naturalization/Citizenship D N565 Form Revision 012819 edits.xlsx	Form and Instruction

IC Title:

Application for Replacement Naturalization/Citizenship Document - Electronic

Agency IC Tracking Number:

1615-0091

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 1454

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N-565	Application for Replacement Naturalization/Citizenship Document (Electronic)	N565 Form Revision 012819 edits.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: DHS/USCIS-001 Alien File, Index, and National File Tracking System of Records

FR Citation: 82 FR 43556

Number of Respondents: 9,138

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 33 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	9,138	9,138
Annual IC Time Burden (Hours)	8,380	8,380
Annual IC Cost Burden (Dollars)	1,119,405	1,119,405

Documents for IC

table that charts IC Documents
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.