Evacuee Manifest and Promissory Note

OMB 1405-0211

OMB 1405-0211

The DS 5528, Evacuee Manifest and Promissory Note, is used to document the evacuation of persons from abroad when their lives are endangered by war, civil unrest, or natural disaster; document issuance of a crisis evacuation loan; to obtain a Privacy Act waiver to share information about the welfare of a citizen or lawful permanent resident with designated persons; and to facilitate debt collection.

The latest form for Evacuee Manifest and Promissory Note expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form and Instruction
Form and Instruction
Supplementary Document
Supplementary Document
Justification for No Material/Nonsubstantive Change
Justification for No Material/Nonsubstantive Change
Supporting Statement A
Supplementary Document
All Historical Document Collections
 Reinstatement without change of a previously approved collection 2024-04-15
Revision of a currently approved collection 2020-07-31
Approved without change
 No material or nonsubstantive change to a currently approved collection 2019-06-26
Approved without change
 No material or nonsubstantive change to a currently approved collection 2018-07-11
Approved without change
 Extension without change of a currently approved collection 2017-05-12
Approved with change
 No material or nonsubstantive change to a currently approved collection 2016-02-12
Improperly submitted and continue
 No material or nonsubstantive change to a currently approved collection 2016-01-29
Improperly submitted and continue
 Revision of a currently approved collection 2016-01-28
Approved with change
 Extension without change of a currently approved collection 2015-04-14
Approved with change
 New collection (Request for a new OMB Control Number) 2013-05-14
© 2024 OMB.report | Privacy Policy