Affidavit Regarding A Change of Name

ICR 202310-1405-004

OMB: 1405-0133

Federal Form Document

IC Document Collections
ICR Details
1405-0133 202310-1405-004
Received in OIRA 202007-1405-001
STATE/AFA
Affidavit Regarding A Change of Name
Revision of a currently approved collection   No
Regular 10/26/2023
  Requested Previously Approved
36 Months From Approved 10/31/2023
3,617 2,592
2,411 1,728
0 14,878

The Affidavit Regarding a Change of Name (DS-60) is submitted in conjunction with an application for a U.S. passport. It is used by Passport Services to collect information for the purpose of establishing that a passport applicant has adopted a new name without formal court proceedings or a marriage and has publicly and exclusively use the adopted name over a long period of time (generally five years). The affidavit must be executed by an affiant who has personal knowledge of the facts of the applicant's use of both their birth name and their newly adopted name in question.

US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
   EO: EO 11295 Name/Subject of EO: Rules governing the granting, issuing, and verifying of United States passports
  
None

Not associated with rulemaking

  88 FR 12117 08/14/2023
88 FR 12245 10/26/2023
No

1
IC Title Form No. Form Name
Affidavit Regarding A Change of Name DS-60 Affidavit Regarding a Change of Name
Affidavit Regarding A Change of Name DS-60 Affidavit Regarding A Change of Name

  Total Request 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 3,617 2,592 0 3,617 -2,592 0
Annual Time Burden (Hours) 2,411 1,728 0 2,411 -1,728 0
Annual Cost Burden (Dollars) 0 14,878 67,532 -67,532 -14,878 0
Yes
Changing Regulations
No
The projected average number of form DS-11 respondents from FY 2023-2025 is 12,055,600. Through a Department-led time and motion study, it was determined that Form DS-60 was attached to 0.03 percent of Form DS-11 receipts. Therefore, the projected number of annual respondents for Form DS-60 is 3,617.

$3,825
No
    Yes
    Yes
No
No
No
No
Alan Jones 202 717-0683

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/26/2023


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