Form 10-595, "Senior Pass" (Mail-in Applicants)

The Interagency Access Pass and Senior Pass Application Processes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0252 can be found here:

Documents and Forms

Document Name Document Type
Form 10-595 Form 10-595, "Senior Pass" (Mail-in Applicants) Form and Instruction
10-595 The America the Beautiful – the National Parks and Feder 10-595 Senior Pass 6-29-2020.pdf store.usgs.gov/pass/senior_pass_application.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Form 10-595, "Senior Pass" (Mail-in Applicants)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-595	The America the Beautiful – the National Parks and Federal Recreational Lands Senior Pass	10-595 Senior Pass 6-29-2020.pdf	https://store.usgs.gov/pass/senior_pass_application.pdf	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title: The ‘America the Beautiful—The National Parks and Federal Recreational Lands Pass’ System, DOI–06	FR Citation: 80 FR 63246

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40,000	10,250	29,750
Annual IC Time Burden (Hours)	6,667	1,709	4,958
Annual IC Cost Burden (Dollars)	444,000	126,865	317,135

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.