Foreign Diplomatic Services Applications (FDSA)

Forms and Documents

Document Name	Status
Form DS-1972 United States Department of State Driver License and Tax Exemption Card Application Form and Instruction	Unchanged
Form DS-1504 Request for Customs Clearance of Merchandise Form and Instruction	New
Form DS-4140 Application for OFM Website Account Form and Instruction	New
Form DS-4138 Request for Escort Screening Courtesies Form and Instruction	New
Form DS-4139 Photograph and Signature Card Form and Instruction	New
Form DS-2008E Application for Notification of Termination of Diplomatic, Consular, or Foreign Government Employment - eGov System Form and Instruction	Unchanged
Form DS-2007 Notification of Dependents of Diplomatic, Consular and Foreign Government Employees Form	Unchanged
Form DS-2006E Notification of Change Identification Card Request - eGov System Form and Instruction	Unchanged
Form DS-2006 Notification of Change Identification Card Request Form	Unchanged
Form DS-2005 Application for Notification of Appointment for Honorary Consular Officer Form	Unchanged
Form DS-2004 Applying for a Notification of Appointment of Foreign Government Employee Form	Unchanged
Form DS-2003E Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer - eGov System Form and Instruction	Unchanged
Form DS-2003 Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer Form	Unchanged
Form DS-1504 Request for Customs Clearance of Merchandise Form	Unchanged
Form DS-104E Application for Replacement Plates - eGov System Form and Instruction	Unchanged
Form DS-99E Application for Exemption of Gasoline Tax - eGov System Form and Instruction	Unchanged
Form DS-102E Application for (Motor Vehicle) Title - eGov System Form and Instruction	Unchanged
Form DS-102 Application for (Motor Vehicle) Title Form	Unchanged
Form DS-101E Application for Registration (Personal Vehicle) - eGov System Form and Instruction	Unchanged
Form DS-101 Application for Registration (Personal Vehicle) Form	Unchanged
Form DS-100E Application for Registration (Mission Vehicle) - eGov System Form and Instruction	Unchanged
Form DS-100 Application for Registration (Mission Vehicles) Form	Unchanged
Form DS-98E Application for a Diplomatic Tax Exemption for Taxes on Utilities - eGov System Form and Instruction	Unchanged
Form DS-1972T Application for a Mission or Personal Tax Exemption Card - eGov System Form and Instruction	Unchanged
Form DS-1972D United States Department of State Driver License - eGov System Form and Instruction	Unchanged
DS-1504 Customs e-Gov format.pdf Supplementary Document	2010-07-06
DS4140 (2).pdf Supplementary Document	2010-07-06
DS4139 (2).pdf Supplementary Document	2010-07-06
ds4138.pdf Supplementary Document	2010-07-06
LEGAL AUTHORITIES.doc Supplementary Document	2009-05-22
7) eGov user screens part 2.doc Supplementary Document	2009-05-22
7) eGov user screens part 1.doc Supplementary Document	2009-05-22
Supporting Statement For OFM PRAct submission 30-Day notice.docx Supporting Statement A	2010-10-06

IC Document Collections

IC ID	Document Title	Status
38741	United States Department of State Driver License and Tax Exemption Card Application Form and Instruction	Unchanged
193694	Request for Customs Clearance of Merchandise Form and Instruction	New
192683	Application for OFM Website Account Form and Instruction	New
192682	Request for Escort Screening Courtesies Form and Instruction	New
192681	Photograph and Signature Card Form and Instruction	New
189076	Application for Notification of Termination of Diplomatic, Consular, or Foreign Government Employment - eGov System Form and Instruction	Unchanged
189075	Notification of Dependents of Diplomatic, Consular and Foreign Government Employees Form	Unchanged
189074	Notification of Change Identification Card Request - eGov System Form and Instruction	Unchanged
189073	Notification of Change Identification Card Request Form	Unchanged
189071	Application for Notification of Appointment for Honorary Consular Officer Form	Unchanged
189070	Applying for a Notification of Appointment of Foreign Government Employee Form	Unchanged
189069	Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer - eGov System Form and Instruction	Unchanged
189068	Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer Form	Unchanged
189067	Request for Customs Clearance of Merchandise Form	Unchanged
189066	Application for Replacement Plates - eGov System Form and Instruction	Unchanged
189065	Application for Exemption of Gasoline Tax - eGov System Form and Instruction	Unchanged
189064	Application for (Motor Vehicle) Title - eGov System Form and Instruction	Unchanged
189063	Application for (Motor Vehicle) Title Form	Unchanged
189062	Application for Registration (Personal Vehicle) - eGov System Form and Instruction	Unchanged
189061	Application for Registration (Personal Vehicle) Form	Unchanged
189059	Application for Registration (Mission Vehicle) - eGov System Form and Instruction	Unchanged
189058	Application for Registration (Mission Vehicles) Form	Unchanged
189049	Application for a Diplomatic Tax Exemption for Taxes on Utilities - eGov System Form and Instruction	Unchanged
189048	Application for a Mission or Personal Tax Exemption Card - eGov System Form and Instruction	Unchanged
189036	United States Department of State Driver License - eGov System Form and Instruction	Unchanged

ICR Details

OMB Control No: 1405-0105	ICR Reference No: 200911-1405-008
Status: Historical Active	Previous ICR Reference No: 200904-1405-006
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Foreign Diplomatic Services Applications (FDSA)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/15/2010
	Date Received in OIRA: 07/06/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved	08/31/2012
Responses	99,166	0	69,772
Time Burden (Hours)	31,298	0	23,753
Cost Burden (Dollars)	0	0	0

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Abstract: Used by foreign VIP's used to request diplomatic services.

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Authorizing Statute(s): US Code: 22 USC 4301 Name of Law: Foreign Missions Act
  

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:
	75 FR 59	03/29/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 124	06/29/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 25

IC Title	Form No.	Form Name
Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer - eGov System	DS-2003E	Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer and Foreign Government Employee
Application for a Diplomatic Tax Exemption for Taxes on Utilities - eGov System	DS-98E	Application for a Diplomatic Tax Exemption for Taxes on Utilities
Request for Customs Clearance of Merchandise	DS-1504	Request for Customs Clearance of Merchandise
United States Department of State Driver License and Tax Exemption Card Application	DS-1972	U.S. Department of State Driver License & Tax Exemption Card Application
Application for Registration (Personal Vehicle)	DS-101	Application for Registration (Personal Vehicle)
Request for Escort Screening Courtesies	DS-4138	Request for Escort Screening Courtesies
Application for OFM Website Account	DS-4140	Application for OFM Website Account
Photograph and Signature Card	DS-4139	Photograph and Signature Card
Request for Customs Clearance of Merchandise	DS-1504	Request for Customs Clearance of Merchandise
Application for Notification of Termination of Diplomatic, Consular, or Foreign Government Employment - eGov System	DS-2008E	Application for Notification of Termination of Diplomatic, Consular, or Foreign Government Employment
Notification of Change Identification Card Request	DS-2006	Notification of Change Identification Card Request
Application for Replacement Plates - eGov System	DS-104E	Application for Replacement Plates
Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer	DS-2003	Applying for a Notification of Appointment of Foreign Diplomatic Officer, Career Consular Officer
Notification of Change Identification Card Request - eGov System	DS-2006E	Notification of Change Identification Card Request
Notification of Dependents of Diplomatic, Consular and Foreign Government Employees	DS-2007	Notification of Dependents of Diplomatic, Consular and Foreign Government Employees
Applying for a Notification of Appointment of Foreign Government Employee	DS-2004	Applying for a Notification of Appointment of Foreign Government Employee
Application for Registration (Personal Vehicle) - eGov System	DS-101E	Application for Registration (Personal Vehicle)
Application for (Motor Vehicle) Title	DS-102	Application for (Motor Vehicle) Title
Application for Exemption of Gasoline Tax - eGov System	DS-99E	Application for Exemption of Gasoline Tax
Application for (Motor Vehicle) Title - eGov System	DS-102E	Application for (Motor Vehicle) Title
Application for Notification of Appointment for Honorary Consular Officer	DS-2005	Application for Notification of Appointment for Honorary Consular Officer
United States Department of State Driver License - eGov System	DS-1972D	United States Department of State Driver License
Application for a Mission or Personal Tax Exemption Card - eGov System	DS-1972T	Application for a Mission or Personal Tax Exemption Card
Application for Registration (Mission Vehicles)	DS-100	Application for Registration (Mission Vehicles)
Application for Registration (Mission Vehicle) - eGov System	DS-100E	Application for Registration (Mission Vehicle)

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ICR Summary of Burden

	Total Approved	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	99,166	69,772	0	29,394	0	0
Annual Time Burden (Hours)	31,298	23,753	0	7,545	0	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: Forms DS-4138, DS-4139, DS-4140, DS-1504 are being combined with the existing Foreign Diplomatic Service Application (DFSA) Collection as additional items that also support the Department of State's effort to ensure that the benefits, privileges, and immunities of such entities (designated international organizations), and their eligible personnel assigned to duty in the United States are properly implemented and respected.

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Annual Cost to Federal Government: $3,142,393

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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]? Uncollected

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

Is this ICR related to the Pandemic Response? Uncollected

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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: 07/06/2010

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