Application for Surrogate Association for DoD Self-Service (DS) Logon

ICR 201807-0704-005

OMB: 0704-0559

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2018-07-27
Supplementary Document
2018-07-27
Supplementary Document
2018-07-27
Supporting Statement A
2018-07-27
Supplementary Document
2018-07-26
Supplementary Document
2016-10-06
IC Document Collections
ICR Details
0704-0559 201807-0704-005
Active 201610-0704-002
DOD/DODDEP
Application for Surrogate Association for DoD Self-Service (DS) Logon
Existing collection in use without an OMB Control Number   No
Regular
Approved without change 09/11/2018
Retrieve Notice of Action (NOA) 07/27/2018
The Department must report this collection in the Information Collection Budget.
  Inventory as of this Action Requested Previously Approved
09/30/2021 36 Months From Approved
5,000 0 0
167 0 0
9,870 0 0

This form is submitted to DoD to establish a Defense Enrollment Eligibility Reporting System (DEERS) record and surrogate association for issuance of a DoD Self-Service (DS) Logon. A surrogate may be established: (1) As the custodian of an unmarried minor child(ren) of a deceased Service member who is under age 18, who is at least 18 but under 23 and attending school full-time, or who is incapacitated. (2) As the agent of an incapacitated dependent (e.g., spouse, parent). (3) As the agent of a wounded, ill, or incapacitated Service member.

US Code: 10 USC 1044a Name of Law: null
  
None

0790-AJ36 Final or interim final rulemaking 81 FR 76325 11/02/2016

83 FR 35625 07/27/2018
No

1
IC Title Form No. Form Name
Application for Surrogate Association for DoD Self-Service (DS) Logon Form DD Form X683 Application for Surrogate Association for DoD Self-Service (DS) Logon

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,000 0 0 5,000 0 0
Annual Time Burden (Hours) 167 0 0 167 0 0
Annual Cost Burden (Dollars) 9,870 0 0 9,870 0 0
Yes
Miscellaneous Actions
No
There are no changes in burden as this is a new collection. OMB had previously issued a comment on the rule, which generated the OMB Control Number.

$4,109
No
    Yes
    Yes
No
No
No
Uncollected
Ben McAlduff 480 316-1398 benjamin.d.mcalduff.ctr@mail.mil

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/27/2018


© 2024 OMB.report | Privacy Policy