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Department of Defense Medical Examiniation Review Board Medical Information Collection Forms
Department of Defense Medical Examiniation Review Board Medical Information Collection Forms
OMB: 0704-0396
IC ID: 5464
OMB.report
DOD/DODDEP
OMB 0704-0396
ICR 200005-0704-007
IC 5464
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0396 can be found here:
2006-08-29 - Extension without change of a currently approved collection
2003-07-08 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Department of Defense Medical Examiniation Review Board Medical Information Collection Forms
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
DD-2374/-2375
No
No
Form
DD-2380/-2381
No
No
Form
DD-2370/-2372
No
No
Form
DD-2382/-2383
No
No
Form
DD-2492/-2632
No
No
Form
DD-2351/-2369
No
No
Form
DD-2480/-2489
No
No
Form
DD-2378/-2379
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
19,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
19,000
0
0
0
0
19,000
Annual IC Time Burden (Hours)
19,000
0
0
0
0
19,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.