Request for Authentications Service

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-4194 Request for Authentications Service	Form and Instruction	Unchanged	Available
DS-4194_PRA Support Statement.docx	Supporting Statement A	Uploaded 2023-01-12	Available
PN11584_FR Published_11.30.2021.pdf	Supplementary Document	Uploaded 2022-05-27	Available
11501_PublishedFR_08-18-2021.pdf	Supplementary Document	Uploaded 2022-05-27	Available
Legal Authorities.docx	Supplementary Document	Uploaded 2021-12-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
250865	Request for Authentications Service	Form and Instruction	Unchanged	Request for Authentications Service

ICR Details

OMB Control No: 1405-0254	ICR Reference No: 202301-1405-003
Status: Active	Previous ICR Reference No: 202112-1405-012
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Request for Authentications Service
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/12/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/12/2023
Terms of Clearance: Prior to resubmission, the agency will ensure this form can be completed and submitted digitally, without the need to print or otherwise physically handle or transmit the form. The agency will also ensure it can accept payment from respondents through a web-based option. Finally, the agency will evaluate and respond to the thirty-day comment received on this information collection related to updating the countries listed on the form.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2025	36 Months From Approved
Responses	47,094	0	0
Time Burden (Hours)	7,849	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Request for Authentication Services (Form DS-4194) is used by individuals, institutions, and government agencies, to request the services provided by the U.S. Department of State’s Office of Authentications within the Bureau of Consular Affairs, Passport Services Directorate, Support Operations, Office of Technical Operations (CA/PPT/S/TO/AUT). This office provides authentication services to U.S. citizens and foreign nationals for documents to be used for legal and administrative purposes abroad under the seal of the U.S. Department of State.

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Authorizing Statute(s): US Code: 22 USC 2657 Name of Law: Custody of Seals and Property
  

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:
	86 FR 46308	08/18/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 68041	11/30/2021
Did the Agency receive public comments on this ICR? Yes

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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
Request for Authentications Service	DS-4194	Request for Authentications Service

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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	47,094	0	0	47,094	0	0
Annual Time Burden (Hours)	7,849	0	0	7,849	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: This is a new collection. Please see supporting statement.

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Annual Cost to Federal Government: $270,563

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: 01/12/2023

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