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60-Day Notice of Proposed Information Collection: Application for Additional Visa Pages or Miscellaneous Passport Services

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Information about this document as published in the Federal Register.

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Notice of request for public comment.


The Department of State is seeking Office of Management and Start Printed Page 22938Budget (OMB) approval for the information collection described below. In accordance with the Paperwork Reduction Act of 1995, we are requesting comments on this collection from all interested individuals and organizations. The purpose of this notice is to allow 60 days for public comment preceding submission of the collection to OMB.


The Department will accept comments from the public up to June 17, 2013.


You may submit comments by any of the following methods:

  • Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to comment on this notice by going to You can search for the document by entering “Public Notice 8276” in the Search bar. If necessary, use the Narrow by Agency filter option on the Results page.
  • Email:
  • Mail: PPT Forms Officer, U.S. Department of State, 2100 Pennsylvania Avenue NW., Room 3030, Washington, DC 20037.
  • Fax: (202) 663-2410.
  • Hand Delivery or Courier: PPT Forms Officer, U.S. Department of State, 2100 Pennsylvania Avenue NW., Room 3030, Washington, DC 20037.

You must include the DS form number (if applicable), information collection title, and the OMB control number in any correspondence.

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Direct requests for additional information regarding the collection listed in this notice, including requests for copies of the proposed collection instrument and supporting documents, to PPT Forms Officer, U.S. Department of State, 2100 Pennsylvania Avenue NW., Room 3030, Washington, DC 20037 who may be reached on (202) 663-2457 or at

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  • Title of Information Collection: Application for Additional Visa Pages or Miscellaneous Passport Services.
  • OMB Control Number: 1405-0159.
  • Type of Request: Revision of a Currently Approved Collection.
  • Originating Office: Bureau of Consular Affairs, Passport Services, Office of Program Management and Operational Support, Program Coordination Division (CA/PPT/PMO/PC).
  • Form Number: DS-4085.
  • Respondents: Individuals or Households.
  • Estimated Number of Respondents: 68,559 respondents per year.
  • Estimated Number of Responses: 68,559 responses per year.
  • Average Time Per Response: 20 minutes, or 0.3333 hour.
  • Total Estimated Burden Time: 22,851 hours per year.
  • Frequency: On occasion.
  • Obligation to Respond: Required to Obtain or Retain a Benefit.

We are soliciting public comments to permit the Department to:

  • Evaluate whether the proposed information collection is necessary for the proper functions of the Department.
  • Evaluate the accuracy of our estimate of the time and cost burden for this proposed collection, including the validity of the methodology and assumptions used.
  • Enhance the quality, utility, and clarity of the information to be collected.
  • Minimize the reporting burden on those who are to respond, including the use of automated collection techniques or other forms of information technology.

Please note that comments submitted in response to this Notice are public record. Before including any detailed personal information, you should be aware that your comments as submitted, including your personal information, will be available for public review.

Abstract of Proposed Collection

Under 22 United States Code (U.S.C.) Section 211a et seq. and Executive Order 11295 (August 5, 1966), the Secretary of State has authority to issue U.S. passports to U.S. citizens and non-citizen nationals. When the bearer of a valid U.S. passport applies for the addition of visa pages to that passport, the Department must confirm the applicant's identity and eligibility to receive passport services before the Department can return the passport to the applicant with additional visa pages. Form DS-4085 requests information that is necessary to determine whether the applicant is eligible to receive passport services in accordance with the requirements of Title III of the Immigration and Nationality Act (INA) (U.S.C. sections 1402-1504), the regulations at 22 CFR parts 50 and 51, and other applicable authorities.


Passport Services collects information from U.S. citizens and non-citizen nationals when they complete and submit the Application for Additional Visa Pages or Miscellaneous Passport Services. Passport applicants can either download the DS-4085 from the internet or obtain one from an Acceptance Facility/Passport Agency. The form must be completed, signed, and submitted along with the applicant's valid U.S. passport.

Additional Information

In addition to general format changes, the following content changes have been made to the form.

  • Page 1 Form—Under Line Item 15, Travel Plans: The words “Date of Trip” have been replaced with “Departure Date” and the words “Duration of Trip” have been replaced with “Return Date”.
  • Page 1 Form—In the first signature block, “Applicant's Signature—age 16 and older”, the word “Legal” has been added before “Signature”.
  • Page 1 Form—The second signature block “Parent's/Legal Guardian's Signature (if identifying minor)” has been revised to now read “Mother/Father/Parent/Legal Guardian's Signature (if identifying minor)”.

The Department estimates that these changes will not result in an increase in the current burden time of 20 minutes.

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Dated: March 19, 2013.

Brenda S. Sprague,

Deputy Assistant Secretary for Passport Services, Bureau of Consular Affairs, Department of State.

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[FR Doc. 2013-09038 Filed 4-16-13; 8:45 am]