Answers to OIRA

2024 04 03 856 am Answers to OIRA 2020 Questions DS 3072 Supporting Statement CLEAN NO COMMENTS.docx

Repatriation/Emergency Medical and Dietary Assistance Loan Application

Answers to OIRA

OMB: 1405-0150

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OMB Comment 1. Kyle S. Gardiner EOP/OMB October 20, 2020 Feedback on DS-3072:

  1. Please revise the instruction language in box 34. Currently it reads “Minor Children or Incapacitated/Incompetent Adults to be Repatriated or to Receive Emergency Medical and Dietary Assistance, list below.” We consider this unclear verbiage. We suggest as an alternative, “If you are responsible for any minor children or incapacitated/incompetent adults who also need to be repatriated or receive emergency medical or dietary assistance, please list each one below.”

  2. Please ensure full name, signature, and date fields are fillable (see comments below).



Department of State Response to OMB Comment 1:

  1. Form DS-3072 has been updated in the box 34 with language suggested from our Legal team.

  2. Box 92, 93, 95, 96, 98 and 99, Signature and date fields are fillable.



The form changes are as follows:

  • Revised section 34 for clarity pursuant to OIRA’s request.  The instruction at section 34 previously read “Accompanying Minor Children or Incapacitated/Incompetent Adults Only, list below.  Check here if none.”   We propose revising to provide “If including minor children or incapacitated/incompetent adults, please list below.  Check here if none.”

  • Updated lines 92 and 93 to make signature and date fields fillable.

  • Updated lines 95, 96, 98, and 99 to make signature and date fields fillable.

  • Updated section 97 to provide new language regarding consent to release information to the U.S. Department of Health and Human Services under the Privacy Act of 1974.   

  • Updated Privacy Act and Paperwork Reduction Act Statement updated.



OMB Comment 2. Kyle S. Gardiner EOP/OMB October 20, 2020

In most contexts, OIRA is deferential to CA as it works toward determining appropriate electronic signature modalities for many of its collections. However, those are largely tied to passport/visa forms. For the DS-3072 however (and also for the DS-5528), there is no justifiable reason for not accepting an electronic signature on the signature field (this can be a typed signature, signed via a mouse tracing, etc.), as electronic signatures are legally equivalent to wet signatures. Allowing respondents to type their name onto the signature field and then email the form to post, for instance, is an equally valid means of signature to a hand-delivered wet-signed document.

1 - Please ensure that the final version of this PDF has a fillable field in the signature/date line, and that the instructions do not imply that the form needs to be printed/wet-signed. To the extent that posts already transmit and receive this form via email, respondents should be encouraged to electronically sign as an alternative to printing and signing.

Finally, please ensure this section is modified to reflect these changes.



Department of State Response to OMB Comment 2:

Form DS-3072 has been updated and the signature and dates can be filled electronically.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGaw, Monica A
File Modified0000-00-00
File Created2024-07-22

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