Affidavit of Physical Presence or Residence, Parentage and Support

ICR 201206-1405-001

OMB: 1405-0187

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2012-06-05
Supporting Statement A
2012-06-05
IC Document Collections
ICR Details
1405-0187 201206-1405-001
Historical Active 200905-1405-003
STATE/AFA
Affidavit of Physical Presence or Residence, Parentage and Support
Revision of a currently approved collection   No
Regular
Approved with change 12/16/2012
Retrieve Notice of Action (NOA) 06/05/2012
OMB notes this information collection request should have been submitted as a revision. State Department will report upon its next submission to OMB for approval progress towards full GPEA compliance.
  Inventory as of this Action Requested Previously Approved
12/31/2015 36 Months From Approved 12/31/2012
17,784 0 15,026
8,892 0 7,513
0 0 0

The purpose of the information collection is to determine if U.S. citizen/national parent(s) possesses the requisite physical presence or residence in the United States prior to their child's birth to transmit U.S. citizenship (or U.S. non-citizen nationality) to the child, to establish parentage of the child, and to fulfill the requirements of 8 U.S.C. 1409(a) which requires a written statement of financial support to be provided by U.S. citizen fathers for children born out of wedlock.

US Code: 8 USC 1401, 1408, 1409 Name of Law: Aliens and Nationality
  
None

Not associated with rulemaking

  77 FR 4858 01/31/2012
77 FR 32710 06/01/2012
No

1
IC Title Form No. Form Name
Affidavit of Parentage, Physical Presence and Support DS-5507 Affidavit of Physical Presence or Residence, Parentage and Support

  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 17,784 15,026 0 0 2,758 0
Annual Time Burden (Hours) 8,892 7,513 0 0 1,379 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
Burden change due to increased number of respondents.

$60,110
No
No
No
No
No
Uncollected
Derek Rivers 202 736-9082 RiversDA@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.
06/05/2012


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