Application for Additional Visa Pages or Miscellaneous Passport Services

ICR 201102-1405-004

OMB: 1405-0159

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2011-02-08
Justification for No Material/Nonsubstantive Change
2010-02-23
Supporting Statement A
2011-02-08
IC Document Collections
ICR Details
1405-0159 201102-1405-004
Historical Active 201002-1405-001
STATE/AFA
Application for Additional Visa Pages or Miscellaneous Passport Services
Revision of a currently approved collection   No
Regular
Approved without change 02/23/2011
Retrieve Notice of Action (NOA) 02/08/2011
This form will expire on December 31, 2013 at the request of the Department of State.
  Inventory as of this Action Requested Previously Approved
12/31/2013 12/31/2013 02/28/2011
146,000 0 60,000
48,667 0 20,000
17,645,300 0 843,000

This form will be used by U.S. citizens and non-citizen nationals who require additional visa pages to be added to their traditional U.S. passport or seek additional miscellaneous passport services.

US Code: 22 USC 211a Name of Law: Immigration and Nationality Act (INA)
  
None

Not associated with rulemaking

  75 FR 118 06/21/2010
75 FR 197 10/13/2010
Yes

  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 146,000 60,000 0 0 86,000 0
Annual Time Burden (Hours) 48,667 20,000 0 0 28,667 0
Annual Cost Burden (Dollars) 17,645,300 843,000 0 16,802,300 0 0
No
No
The changes indicated are due to an increase in respondents and a change in fees.

$12,320
No
No
No
No
No
Uncollected
Alexys Garcia 202 736-9216 garciaaa@state.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/08/2011


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