Information Collection

Affidavit Regarding A Change of Name

IC 263050 under ICR 202310-1405-004 · OMB 1405-0133.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-60 Affidavit Regarding A Change of Name	Form
DS-60 Affidavit Regarding A Change of Name DS-10_Expires 103123_OMB No. 1405-0132_30-Day FRN_PDF Fillable_Draft.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	DS-60	Affidavit Regarding A Change of Name	DS-10_Expires 103123_OMB No. 1405-0132_30-Day FRN_PDF Fillable_Draft.pdf		No		Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Affidavit Regarding A Change of Name

FR Citation: 85 FR 12245

Number of Respondents: 3,617

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,617	0	3,617
Annual IC Time Burden (Hours)	2,411	0	2,411
Annual IC Cost Burden (Dollars)	0	67,532	-67,532

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.