30-Day Notice of Proposed Information Collection: DS 4079, Questionnaire-Information for Determining Possible Loss of United States Citizenship, (New-OMB No.1405-XXXX)

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The Department of State has submitted the following information collection request to the Office of Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Questionnaire: Information for Determining Possible Loss of United States Citizenship. OMB Control Number: New-OMB No.1405-XXXX. Type of Request: New Information Collection. Originating Office: Bureau of Consular Affairs, Overseas Citizens Services (CA/OCS). Form Number: DS 4079. Respondents: United States Citizens. Estimated Number of Respondents: 2,298. Estimated Number of Responses: 2,298. Average Hours per Response: 15 minutes. Total Estimated Burden: 575 hours. Frequency: On Occasion. Obligation to Respond: Required to obtain or retain benefits.