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Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor Under Age 16
Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor Under Age 16
OMB: 1405-0216
IC ID: 207427
OMB.report
STATE/AFA
OMB 1405-0216
ICR 202312-1405-001
IC 207427
( )
Documents and Forms
Document Name
Document Type
Form DS-5525
Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor Under Age 16
Form and Instruction
DS-5525 STATEMENT OF EXIGENT/SPECIAL FAMILY CIRCUMSTANCES FOR IS
DS-5525_30day_2019_Form (PDF)_FINAL.pdf
www.travel.state.gov
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor Under Age 16
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
22 CFR 34,50-51 (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-5525
STATEMENT OF EXIGENT/SPECIAL FAMILY CIRCUMSTANCES FOR ISSUANCE OF A U.S. PASSPORT TO A MINOR UNDER AGE 16
DS-5525_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:
12,484
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
0
0
0
-12,484
12,484
0
Annual IC Time Burden (Hours)
0
0
0
-6,242
6,242
0
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.