Information Collection

Statement of Non-Receipt of a U.S. Passport

IC 263051 under ICR 202310-1405-005 · OMB 1405-0146.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-86 Statement of Non-Receipt of a U.S. Passport	Form and Instruction
DS-86 Statement of Non-Receipt of a U.S. Passport DS-86_Expires 103123_OMB No. 1405-0146_30-Day FRN_PDF Fillable_Draft.pdf	Form and Instruction

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 and Instruction	DS-86	Statement of Non-Receipt of a U.S. Passport	DS-86_Expires 103123_OMB No. 1405-0146_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: Statement of Non-Receipt of a U.S. Passport

FR Citation: 88 FR 12245

Number of Respondents: 18,260

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	18,260	0	18,260
Annual IC Time Burden (Hours)	4,565	0	4,565
Annual IC Cost Burden (Dollars)	0	12,786	-12,786

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.