Repatriation/Emergency Medical and Dietary Assistance Loan Application

OMB 1405-0150

The DS-3072 is an application for an emergency loan for a destitute U.S. citizen and/or dependent to return to the United States, an application for a destitute U.S. citizen abroad to receive emergency medical and dietary assistance and an application for a U.S. citizen and/or dependent and a third country or host country national to receive a loan to assist in his or her repatriation to the United States and/or to provide them with the funds needed to address their emergency medical and/or dietary needs.

The latest form for Repatriation/Emergency Medical and Dietary Assistance Loan Application expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DS-3072 Repatriation/Emergency Medical and Dietary Assistance Loan Application Form and Instruction
Form DS-3072 Repatriation/Emergency Medical and Dietary Assistance Loan Application Form and Instruction
Justification for Non-substantive change.docx Justification for No Material/Nonsubstantive Change
Justification for Non-substantive change.docx Justification for No Material/Nonsubstantive Change
Privacy Act Statement Changes-easy to read.docx Supplementary Document
Privacy Act Statement Changes-easy to read.docx Supplementary Document
2024 04 03 856 am Answers to OIRA 2020 Questions DS 3072 Supporting Statement CLEAN NO COMMENTS.docx Supplementary Document
2024 04 03 856 am Answers to OIRA 2020 Questions DS 3072 Supporting Statement CLEAN NO COMMENTS.docx Supplementary Document
DS-3072 Legal Authorities.doc Supplementary Document
DS-3072 Legal Authorities.doc Supplementary Document
2024 04 03 901 AM DS-3072 Supporting Statement 2020 doc Revised Clean Version NO L COMMENTS OR EDITS.docx Supporting Statement A
2024 04 03 901 AM DS-3072 Supporting Statement 2020 doc Revised Clean Version NO L COMMENTS OR EDITS.docx Supporting Statement A
Repatriation/Emergency Medical and Dietary Assistance Loan Application Form and Instruction
Repatriation/Emergency Medical and Dietary Assistance Loan Application Form and Instruction

All Historical Document Collections

202406-1405-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2024-06-13
202404-1405-003 Approved without change	Reinstatement without change of a previously approved collection	2024-04-15
202007-1405-004	Revision of a currently approved collection	2020-07-31
201906-1405-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-06-26
201706-1405-005 Approved without change	Extension without change of a currently approved collection	2017-06-30
201504-1405-002 Approved with change	Extension without change of a currently approved collection	2015-04-14
201305-1405-001 Approved with change	Revision of a currently approved collection	2013-05-13
201005-1405-005 Approved without change	Extension without change of a currently approved collection	2010-05-13
201003-1405-001 Withdrawn and continue	Revision of a currently approved collection	2010-03-01
200811-1405-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-11-17
200702-1405-001 Approved without change	Revision of a currently approved collection	2007-02-12
200309-1405-007 Approved without change	Extension without change of a currently approved collection	2003-09-30
200303-1405-001 Approved without change	Existing collection in use without an OMB Control Number	2003-03-21