For American readers who do not travel, this article may only set off a vague sense of disquiet.

But for those who either have traveled out of the country, or believe they might “someday” what you are about to read will disturb you.

According to a 60-day notice in the Federal Register, the State Department is seeking approval for a proposed new passport application form, Form DS-5513.

The new Biographical Questionnaire for U.S. Passport allegedly would require 45 minutes to complete, according to the notice. That estimate includes “the time required for searching existing data sources, gathering the necessary data, providing the information and/or documents required, and reviewing the final collection.”

If approved it will be a mandatory form. Failure to provide the information requested “may result in the denial of a United States passport, related documents, or service to the individual seeking such passport, documents or service.”

The notice states that the questionnaire would be submitted in conjunction with the regular application for a passport, and would be required to “establish citizenship, identity, and eligibility for a U.S. Passport Book or Passport Card.

According to the Privacy Act Statement on the proposed form, the information solicited on the form may also be made available as a routine use to other government agencies and private contractors “to assist the U.S. Department of State in adjudicating passport applications and requests for related services, and for law enforcement, fraud prevention, border security, counterterrorism, litigation activities, and administrative purposes.

“The information may be made available to foreign government agencies to fulfill passport control and immigration duties. The information may also be provided to foreign government agencies, international organizations and, in limited cases, private persons and organizations to investigate, prosecute, or otherwise address potential violations of law or to further the Secretary's responsibility for the protection of U.S. citizens and non-citizen nationals abroad.

“The information may be made available to the Department of Homeland Security and private employers for employment verification purposes. “

The proposed form requests the full names of relatives living and deceased, their birthplace (city, state, country), full date of birth, and whether that person was/is a U.S. citizen, for parents, step-parents, siblings, step-siblings, spouse, and children. It's not clear whether aunts, uncles, nephews, nieces and cousins are included as well.

Other items include requests for one's mother's residence one year before applicant's birth (street address, city, state, country) and residence at time of the birth, as well as residence one year after applicant's birth. Another question asks whether the applicant's mother received prenatal or postnatal medical care, and where it was performed – including address, name of doctor and dates of the appointments.

Another question: “Please describe the circumstances of your birth, including the names (as well as address and phone number, if available) of persons present or in attendance at your birth.”

The form also asks for information on baptism, circumcision, confirmation and “other religious ceremony” occurring around the time of birth. Again, details are requested including the name, location of the institution and date of the ceremony.

On the third of five pages, the form asks the applicant to list all residences inside and outside the United States, starting with birth up to the date of the application.

The fourth page requests a list of all current and former places of employment in the United States and abroad. This table includes the name of the workplace, address, city, state, country, time employed, supervisor's name and phone number. Also on this page is a request to list all schools attended by the applicant, inside and outside the U.S., including name, full address and dates of attendance.

The fifth and final page is a signature that all of the above was answered truthfully, under threat of arrest for perjury if not.

According to the proposed form, comments on the accuracy of the 45-minute estimate “and/or recommendations for reducing it” may be sent to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington, DC 20520-2202. Note: You must include the DS form number (DS-5513) and the form title number (Biographical Questionnaire for U.S. Passport) as well as OMB control number (none yet assigned; 1405-XXXX requested by Dept. of State) in the correspondence.