Questionnaire - Loss of United States Nationality; Attestations

ICR 202504-1405-002

OMB: 1405-0178

Federal Form Document

Forms and Documents

Document Name	Status
Form DS-4079 Questionnaire - Loss of United States Nationality; Attestations Form and Instruction	New
Form DS-4079 Questionnaire - Loss of United States Nationality; Attestations Form and Instruction	Unchanged
Justification for using MS Forms for DS 4079 PART I FINAL.docx Justification for No Material/Nonsubstantive Change	2025-04-22
Non-Substantive Change 1405-0178 DS-4079.docx Justification for No Material/Nonsubstantive Change	2025-03-29
4079_Published.pdf Supplementary Document	2023-09-29
PublishedFR_07-19-2023.pdf Supplementary Document	2023-09-28
Legal Authorities.docx Supplementary Document	2023-09-28
1405-0178 Supporting Statement - CLEAN 10.24.2024.docx Supporting Statement A	2024-10-24

IC Document Collections

IC ID	Document Title	Status
274993	Questionnaire - Loss of United States Nationality; Attestations Form and Instruction	New
181472	Questionnaire - Loss of United States Nationality; Attestations Form and Instruction	Unchanged