Information Collection

Electronic Diversity Visa Entry Form

IC 15041 under ICR 200401-1405-001 · OMB 1405-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0153 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Electronic Diversity Visa Entry Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-5501				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,000,000	-2,000,000	8,000,000
Annual IC Time Burden (Hours)	3,000,000	-1,000,000	4,000,000
Annual IC Cost Burden (Dollars)	60,000,000	-20,000,000	80,000,000

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.