Affidavit Regarding A Change of Name

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0133 can be found here:

Documents and Forms

Document Name Document Type
Form DS-60 Affidavit Regarding A Change of Name Form and Instruction
DS-60 Affidavit Regarding a Change of Name DS-60_30day_2020_Form_PDF Fillable.pdf www.travel.state.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Affidavit Regarding A Change of Name	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 50-51 (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-60	Affidavit Regarding a Change of Name	DS-60_30day_2020_Form_PDF Fillable.pdf	www.travel.state.gov	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: Passport Records STATE-26	FR Citation: 76 FR 39466

Number of Respondents: 2,592	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	Previously Approved
Annual Number of Responses for this IC	2,592	-158,647	161,239
Annual IC Time Burden (Hours)	1,728	-105,765	107,493
Annual IC Cost Burden (Dollars)	14,878	-257,616	272,494

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.