Information Collection

Affidavit Regarding A Change of Name

IC 15007 under ICR 202007-1405-001 · OMB 1405-0133.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0133 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-60 Affidavit Regarding a Change of Name Affidavit Regarding A Change of Name	Form and Instruction
DS-60 Affidavit Regarding a Change of Name DS-60_30day_2020_Form_PDF Fillable.pdf	Form and Instruction

IC Title:

Affidavit Regarding A Change of Name

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 50-51 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	DS-60			www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Passport Records STATE-26

FR Citation: 76 FR 39466

Number of Respondents: 2,592

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,592	-158,647	161,239
Annual IC Time Burden (Hours)	1,728	-105,765	107,493
Annual IC Cost Burden (Dollars)	14,878	-257,616	272,494

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].