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Questionnaire - Loss of United States Nationality; Attestations
Questionnaire - Loss of United States Nationality; Attestations
OMB: 1405-0178
IC ID: 181472
OMB.report
STATE/AFA
OMB 1405-0178
ICR 202503-1405-007
IC 181472
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0178 can be found here:
2025-04-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form DS-4079
Questionnaire - Loss of United States Nationality; Attestations
Form and Instruction
Form DS-4079
Questionnaire - Loss of United States Nationality; Attestations
Form and Instruction
DS-4079 Questionnaire - Loss of United States Nationality; Attestations
DS-4079.pdf
Form and Instruction
Information Collection (IC) Details
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