Emergency Loan Application and Evacuation Documentation

Repatriation/Emergency Medical and Dietary Assistance Loan Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0150 can be found here:

Documents and Forms

Document Name Document Type
Form DS-3072 Emergency Loan Application and Evacuation Documentation Form and Instruction
DS-3072 Repatriation/Emergency Medical and Dietary Assistance Lo DS-3072 (5-2013).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Emergency Loan Application and Evacuation Documentation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 22 CFR 71

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-3072	Repatriation/Emergency Medical and Dietary Assistance Loan Application	DS-3072 (5-2013).pdf		No		Paper Only

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,357	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,357	0	181	1,176
Annual IC Time Burden (Hours)	452	256	0	196
Annual IC Cost Burden (Dollars)	86,750	86,750	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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