Application for Additional Visa Pages or Miscellaneous Passport Services

Application for additional VISA Pages or Miscellaneous Passport Services

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0159 can be found here:

Documents and Forms

Document Name Document Type
Form DS-4085 Application for Additional Visa Pages or Miscellaneous Passport Services Form
DS-4085 Application for Additional VISA PAges Internet Form DS-4085.pdf www.travel.state.gov Form
DS-4085 Application for Additional Visa Pages or Miscellaneous P DS-4085 10-25-07.pdf www.travel.state.gov Form and Instruction
DS-4085 Application for additional VISA Pages or Miscellaneous P OMB passback DS-4085 12-11-07.pdf www.travel.state.gov Form and Instruction
Justification of Changes for DS-4085.doc Justification of Changes for DS-4085 IC Document

Information Collection (IC) Details

IC Title:	Application for Additional Visa Pages or Miscellaneous Passport Services	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 50-51 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-4085	Application for Additional VISA PAges	Internet Form DS-4085.pdf	www.travel.state.gov	Yes	No	Fillable Printable
Form and Instruction	DS-4085	Application for Additional Visa Pages or Miscellaneous Passport Services	DS-4085 10-25-07.pdf	www.travel.state.gov	Yes	No	Fillable Printable
Form and Instruction	DS-4085	Application for additional VISA Pages or Miscellaneous Passport Services	OMB passback DS-4085 12-11-07.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	60,000	30,000	30,000
Annual IC Time Burden (Hours)	20,000	10,000	10,000
Annual IC Cost Burden (Dollars)	843,000	421,000	422,000

Documents for IC

Title	Document	Date Uploaded
Justification of Changes for DS-4085	Justification of Changes for DS-4085.doc	10/26/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.