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Supplemental Questionnaire to Determine Entitlement for a U.S. Passport
Supplemental Questionnaire to Determine Entitlement for a U.S. Passport
OMB: 1405-0214
IC ID: 203623
OMB.report
STATE/AFA
OMB 1405-0214
ICR 201908-1405-007
IC 203623
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0214 can be found here:
2024-03-12 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form DS-5513
Supplemental Questionnaire to Determine Entitlement for a U.S. Passport
Form and Instruction
DS-5513 Supplemental Questionnaire to Determine Entitlement for
DS-5513_30day_2019_Form (PDF)-FINAL.pdf
www.travel.state.gov
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Supplemental Questionnaire to Determine Entitlement for a U.S. Passport
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 51.23, 51.40, 51.45
22 CFR 50, B&C (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 and Instruction
DS-5513
Supplemental Questionnaire to Determine Entitlement for a US passport
DS-5513_30day_2019_Form (PDF)-FINAL.pdf
www.travel.state.gov
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Homeland Security
Subfunction:
Border and Transportation Security
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,076
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,076
0
819
0
0
3,257
Annual IC Time Burden (Hours)
5,774
0
1,160
0
0
4,614
Annual IC Cost Burden (Dollars)
0
0
0
0
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.