Information Collection

Supplemental Questionnaire to Determine Identity for a U.S. Passport

IC 203622 under ICR 202403-1405-003 · OMB 1405-0215.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-5520 Supplemental Questionnaire to Determine Identity for a U.S. Passport	Form and Instruction
DS-5520 SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U Form DS-5520_Final_PDF Fillable1.2.pdf www.travel.state.gov	Form and Instruction
DS-5520 SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U Form DS-5520_Final_PDF Fillable1.2.pdf www.travel.state.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 51.23,40,45

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-5520	SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U.S. PASSPORT	Form DS-5520_Final_PDF Fillable1.2.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Passport Records, STATE-26

FR Citation: 81 FR 19863

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	10,000	-11,891	21,891
Annual IC Time Burden (Hours)	7,500	-8,918	16,418
Annual IC Cost Burden (Dollars)	0	0	0

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.