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60-Day Notice of Proposed Information Collection: Repatriation/Emergency Medical and Dietary Assistance Loan Application

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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.


The Department will accept comments from the public up to March 23, 2015.


You may submit comments by any of the following methods:

  • Web: Persons with access to the Internet may comment on this notice by going to You can search for the document by entering “Docket Number: DOS-2015-0002” in the search field. Then click the “Comment Now” button and complete the comment form.
  • Email:
  • Mail: (paper, disk, or CD-ROM submissions): U.S. Department of State, CA/OCS/PMO, SA-17, 10th Floor, Washington, DC 20036.
  • Fax: 202-736-9111.
  • Hand Delivery or Courier: U.S. Department of State, CA/OCS/PMO, 600 19th St. NW., 10th Floor, Washington, DC 20036.

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 Derek Rivers, Bureau of Consular Affairs, Overseas Citizens Services (CA/OCS/PMO), U.S. Department of State, SA-17, 10th Floor, Washington, DC 20036 or at

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  • Title of Information Collection: Repatriation/Emergency Medical and Dietary Assistance Loan Application.
  • OMB Control Number: 1405-0150.
  • Type of Request: Revision.
  • Originating Office: Bureau of Consular Affairs, Overseas Citizens Services (CA/OCS).
  • Form Number: DS-3072.
  • Respondents: U.S. Citizens applying for emergency loan assistance.
  • Estimated Number of Respondents: 1,446.
  • Estimated Number of Responses: 1,446.
  • Average Time per Response: 20 minutes.
  • Total Estimated Burden Time: 482 hours.
  • Frequency: On Occasion.
  • Obligation to Respond: Required to Obtain Benefits.

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.Start Printed Page 2771
  • 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 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 Bureau of Consular Affairs will post this form on Department of State Web sites to give respondents the opportunity to complete the form online, or print the form and fill it out manually and submit the form in person or by fax or mail.

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Dated: December 5, 2014.

Michelle Bernier-Toth,

Managing Director, Bureau of Consular Affairs, Overseas Citizen Services, Department of State.

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[FR Doc. 2015-00782 Filed 1-16-15; 8:45 am]