Information Collection

Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card

IC 271401 under ICR 202410-1405-001 · OMB 1405-0014.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-64 Statement Regarding a Valid Lost or Stolen U.S. Passport Book and/or Card Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card	Form and Instruction
DS-64 Statement Regarding a Valid Lost or Stolen U.S. Passport DS-64_Expires 013125_OMB No 1405-0014_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: 22 CFR 51.8(b)

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-64				Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Statement Regarding a Valid Lost or Stolen U.S. Passport Book and/or Card

FR Citation: 89 FR 12560

Number of Respondents: 435,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	435,000	-208,400	643,400
Annual IC Time Burden (Hours)	36,250	-17,367	53,617
Annual IC Cost Burden (Dollars)	3,132	-1,500	4,632

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.

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