Statement of Non-Receipt of a U.S. Passport

Forms and Documents

Document Name	Status
Form DS-86 Statement of Non-Receipt of a U.S. Passport Form and Instruction	Modified
Final - DS-86_30day_2020_Legal Authorities.docx Supplementary Document	2020-09-10
Final - DS-86_30day_2020_SuppStmnt.docx Supporting Statement A	2020-09-10

IC Document Collections

IC ID	Document Title	Status
15031	Statement of Non-Receipt of a U.S. Passport Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0146	ICR Reference No: 202009-1405-001
Status: Active	Previous ICR Reference No: 201709-1405-004
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Statement of Non-Receipt of a U.S. Passport
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/19/2020
	Date Received in OIRA: 09/10/2020
Terms of Clearance: Agency created fillable PDF as an additional instrument.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved	10/31/2020
Responses	22,868	0	15,330
Time Burden (Hours)	5,717	0	3,833
Cost Burden (Dollars)	20,353	0	3,372

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Abstract: The Statement of Non-Receipt of a U.S. Passport, Form DS-86 is used by the U.S. Department of State to collect information for the purpose of issuing a replacement passport to customers who have not received the passport for which they originally applied.

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Authorizing Statute(s): US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
   EO: EO 11295 Name/Subject of EO: Rules governing the granting, issuing, and verifying of United States passports
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 23882	04/29/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 55058	09/03/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Statement of Non-Receipt of a U.S. Passport	DS-86	Statement of Non-Receipt of a U.S. Passport

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ICR Summary of Burden

	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	22,868	15,330	0	7,538	0	0
Annual Time Burden (Hours)	5,717	3,833	0	1,884	0	0
Annual Cost Burden (Dollars)	20,353	3,372	0	16,981	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The previous submission shows that it calculated the number of applicants using form DS-86 based on the number of applicants who applied for a passport on form DS-11. This is not the best source of data given it does not include applicants who used form DS-86 in response to non-receipt of passports applied for with forms DS-82. As described in question 12, this submission uses data from the number of passports issued with endorsement 47 indicating that the passport was reissued. This data collection is far more accurate.

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Annual Cost to Federal Government: $11,394

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/10/2020

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