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60-Day Notice of Proposed Information Collection: Birth Affidavit

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Notice of request for public comment.


The Department of State is seeking Office of Management and Budget (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.

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The Department will accept comments from the public up to May 12, 2014.


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 8655” 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, 2201 C Street NW., Washington, DC 20520
  • Fax: (202) 485-6496 (include a cover sheet addressed to “PPT Forms Officer” referencing the DS form number, information collection title, and OMB control number)
  • Hand Delivery or Courier: PPT Forms Officer, U.S. Department of State, 2201 C Street NW., Washington, DC 20520

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 U.S. Department of State, Bureau of Consular Affairs, Passport Services, Office of Program Management and Operational Support, 2201 C Street NW., Washington, DC 20520, who may be reached on (202) 485-6373 or at

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  • Title of Information Collection: Birth Affidavit.
  • OMB Control Number: 1405-0132.
  • 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/S/PMO/PC).
  • Form Number: DS-10.
  • Respondents: Individuals or Households.
  • Estimated Number of Respondents: 21,585 per year.
  • Estimated Number of Responses: 21,585 per year.
  • Average Time per Response: 40 minutes or 0.667 hour.
  • Total Estimated Burden Time: 14,390 hours.
  • 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: The Birth Affidavit is submitted in conjunction with an application for a U.S. passport, and is used by Passport Services to collect information for the purpose of establishing the U.S. nationality of a passport applicant who has not submitted an acceptable United States birth certificate with his/her passport application. The Secretary of State is authorized to issue U.S. passports under 22 U.S.C. 211a et seq, 8 U.S.C. 1104, and Executive Order 11295 (August 5, 1966). Pursuant to 22 CFR 51.2, only U.S. nationals may be issued a U.S. passport. Most passport applicants show U.S. nationality by providing a birth certificate showing the applicant was born in the United States. Some applicants, however, may have been born in the United States, but were never issued a birth certificate. Form DS-10 is a form affidavit for completion by a witness to the birth of such an applicant; it collects information relevant to establishing the identity of the affiant, and the birth circumstances of the passport applicant. If credible, the affidavit may permit the applicant to show U.S. nationality based on the applicant's birth in the United States, despite having never been issued a U.S. birth certificate. We use the information collected on the person completing the affidavit to confirm that individual's identity, which is relevant to confirming his or her relationship to the applicant and the likelihood that the affiant has actual knowledge of the circumstances of the applicant's birth.

Methodology: When needed, a Birth Affidavit is completed at the time a U.S. citizen applies for a U.S. passport.

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Dated: February 26, 2014.

Brenda Sprague,

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

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[FR Doc. 2014-05239 Filed 3-10-14; 8:45 am]