Affidavit of Physical Presence or Residence, Parentage and Support

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-5507 Affidavit of Physical Presence or Residence, Parentage, and Support	Form and Instruction	New	Available
Form DS-5507 Affidavit of Physical Presence or Residence, Parentage, and Support	Form and Instruction	New	Repair queued
Form DS-5507 AFFIDAVIT OF PHYSICAL PRESENCE OR RESIDENCE, PARENTAGE AND SUPPORT	Form and Instruction	Unchanged	Available
Form DS-5507 Affidavit of Parentage, Physical Presence and Support	Form and Instruction	Unchanged	Repair queued
Final Supporting Statement - 1405-0187 DS-5507 6-16.docx	Supporting Statement A	Uploaded 2020-06-16	Available
Legal Authorities.docx	Supplementary Document	Uploaded 2018-11-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260882	Affidavit of Physical Presence or Residence, Parentage, and Support	Form and Instruction	New	Affidavit of Physical Presence or Residence, Parentage, and Support
260882	Affidavit of Physical Presence or Residence, Parentage, and Support	Form and Instruction	New
189229	Affidavit of Parentage, Physical Presence and Support	Form and Instruction	Unchanged	AFFIDAVIT OF PHYSICAL PRESENCE OR RESIDENCE, PARENTAGE AND SUPPORT
189229	Affidavit of Parentage, Physical Presence and Support	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1405-0187	ICR Reference No: 202306-1405-005
Status: Historical Active	Previous ICR Reference No: 201811-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Affidavit of Physical Presence or Residence, Parentage and Support
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: 01/11/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/28/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2027	36 Months From Approved	01/31/2024
Responses	63,819	0	17,950
Time Burden (Hours)	31,910	0	8,975
Cost Burden (Dollars)	360,516	0	360,516

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Abstract: The purpose of the information collection is to determine if U.S. citizen/national parent(s) possesses the requisite physical presence or residence in the United States prior to their child's birth to transmit U.S. citizenship (or U.S. non-citizen nationality) to the child, to establish parentage of the child, and to fulfill the requirements of 8 U.S.C. 1409(a) which requires a written statement of financial support to be provided by U.S. citizen fathers for children born out of wedlock.

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Authorizing Statute(s): US Code: 8 USC 1401, 1408, 1409 Name of Law: Aliens and Nationality
  

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:
	88 FR 11983	02/17/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 12092	06/22/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Affidavit of Parentage, Physical Presence and Support	DS-5507	AFFIDAVIT OF PHYSICAL PRESENCE OR RESIDENCE, PARENTAGE AND SUPPORT
Affidavit of Physical Presence or Residence, Parentage, and Support	DS-5507	Affidavit of Physical Presence or Residence, Parentage, and Support

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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	63,819	17,950	0	45,869	0	0
Annual Time Burden (Hours)	31,910	8,975	0	22,935	0	0
Annual Cost Burden (Dollars)	360,516	360,516	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: The Department derived the hour time burden total by multiplying the average number of respondents (45,869) and burden time per response (30 minutes) required to complete this collection divided by one hour (60 minutes). The Department derived the hour cost burden total to respondents by multiplying the weighted hourly wage ($39.21) and the total hour time burden (22,935).

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Annual Cost to Federal Government: $605,812

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: 06/28/2023

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