JADE Act Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-5537 JADE Act Questionnaire	Form and Instruction	New	Available
Form DS-5537 JADE Act Questionnaire	Form	Unchanged	Available
(004) Tab 3 - Legal Authorities -30 Day PRA -DS-5537 - 2026.docx	Supplementary Document	Uploaded 2026-02-12	Available
11979_PublishedFR_2-10-2023.pdf	Supplementary Document	Uploaded 2023-02-10	Available
PublishedFR.pdf	Supplementary Document	Uploaded 2023-02-10	Available
(004) Tab 3 -- Legal Authorities -- 30 Day PRA -- DS-5537.docx	Supplementary Document	Uploaded 2023-02-10	Available
(003) Tab 2 - Supporting Statement -30 Day PRA -DS-5537 - 2026.docx	Supporting Statement A	Uploaded 2026-02-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
279061	JADE Act Questionnaire	Form and Instruction	New	JADE Act Questionnaire
279061	JADE Act Questionnaire	Form and Instruction	New
240716	JADE Act Questionnaire	Form	Unchanged	JADE Act Questionnaire
240716	JADE Act Questionnaire	Form	Unchanged

ICR Details

OMB Control No: 1405-0236	ICR Reference No: 202602-1405-002
Status: Received in OIRA	Previous ICR Reference No: 202302-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: JADE Act Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/12/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	43,300	20,500
Time Burden (Hours)	21,650	10,250
Cost Burden (Dollars)	0	0

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Abstract: The Immigration and Nationality Act (“INA”), 8 U.S.C. § 1101, sets out application and eligibility requirements for aliens seeking to obtain nonimmigrant and immigrant visas. Grounds for the ineligibility of certain individuals to receive a visa or to be admitted to the United States are detailed in INA section 212(a), 8 U.S.C. § 1182(a) and other statutes.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 12867	11/24/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 12943	02/12/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
JADE Act Questionnaire	DS-5537	JADE Act Questionnaire
JADE Act Questionnaire	DS-5537	JADE Act Questionnaire

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	43,300	20,500	0	2,300	20,500	0
Annual Time Burden (Hours)	21,650	10,250	0	1,150	10,250	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Department of State estimates that the annual hour burden to visa applicants as a result of this information collection is 11,400 hours (22,800 applicants x 30 minutes per response). Based on the average local monthly salary in Burma of $135 (or an hourly wage of $0.56), the total cost burden for this collection is $6,384 (11,400 hours x $0.56 hourly wage).

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/12/2026

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