Exchange Form 6450 Military Star Card Application

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OMB NO. 0702-

Read back of form prior to completion of application.

OMB approval expires
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Army & Air Force Exchange Service

Military Star Card Application
(Read Agency Disclosure Notice, Privacy Act Statement, and Instructions before completing form.)

OMB NO. 0702OMB approval expires
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AGENCY DISCLOSURE NOTICE

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The public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate,
Directives Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 (0702-XXXX). Respondents
should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a
collection of information if it does not display a currently valid OMB control number.
PLEASE DO NOT RETURN YOUR RESPONSE TO THE ABOVE ADDRESS.

Responses should be sent to your local Exchange retail facility, to the Exchange office whom provided you the application or the update,
or to the Exchange Military Star at the Army and Air Force Exchange Service, 3911 South Walton Walker Blvd., Dallas, TX 752361598.
PRIVACY ACT STATEMENT

AUTHORITY: Title 10 U.S.C. §3013, “Secretary of the Army”; “Federal Claims Collection Act of 1966” (Pub. L. 89-508, as
amended); “Debt Collection Act of 1982” (Pub. L. 97-365, as amended); 31 CFR 285.11, “Administrative Wage Garnishment”; DoD
7000.14-R, “Department of the Defense Financial Management Regulation”; Army Regulation 215-8/AFI 34-211(I), “Army and Air
Force Exchange Service Operations”; and Executive Order 9397 (SSN), as amended.

PRINCIPAL PURPOSES(S): These forms collect personal information mandatory to process and provide the basis of approving
participation in the Exchange Credit Program.

ROUTINE USE(S): Your records may be disclosed outside of DoD pursuant to Title 5 U.S.C. §552a(b)(3) regarding DoD “Blanket
Routine Uses” published at http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx. This includes disclosure To
the Department of the Treasury, and a debt collection agency with which the United States has contracted for collection services to
recover debts owed to the United States. To any employer (person or entity) that employs the services of others and that pays their
wages or salaries, where the employee owes a delinquent nontax debt to the United States. The term employer includes, but is not
limited to, State and local governments, but does not include any agency of the Federal Government. To consumer reporting
agencies pursuant to 5 U.S.C. 552a(b)(12) as defined in the Fair Credit Reporting Act (14 U.S.C. 1681a(f)) or the Federal Claims
Collection Act of 1966 (31 U.S.C. 3701(a)(3)). The purpose of this disclosure is to aid in the collection of outstanding debts owed to
the Federal government; typically to provide an incentive for debtors to repay delinquent Federal government debts by making these
debts part of their credit report. The disclosure is limited to information necessary to establish the identity of the individual, including
name, address, and taxpayer identification number (Social Security Number); the amount, status, and history of the claim; and the
agency or program under which the claim arose for the sole purpose of allowing the consumer reporting agency to prepare a
commercial credit report. This disclosure will be made only after the procedural requirement of 31 U.S.C. 3711(f) has been followed.
DISCLOSURE: Voluntary, however, failure to provide all the requested information may result in the denial of your application for
inadequate data.

A copy of the Privacy Impact Assessment (PIA) for this collection may be located at http: http://www.aafes.com/aboutexchange/public-affairs/foia.htm.

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SYSTEM OF RECORD NOTICE: AAFES 0702.34 “Accounts Receivable
Files”; http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570128/aafes-070234.aspx

INSTRUCTIONS

1.

Please complete application it in its entirety to ensure timely processing.

2.

Follow all directions printed on the application.

3.

Please read the terms and conditions prior to submitting your application.

4.

Questions should be directed to Military Star Directorate at 877-891-7827.

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