Application for Identification Card/DEERS Enrollment

Forms and Documents

Document Name	Status
Form DD 1172-2 Application for Department of Defense Common Access Card - DEERS Enrollment Form	Modified
SSN Justification Memorandum_2020_signed.PDF Supplementary Document	2020-03-19
0704-0415_SSA_3.20.2020.docx.docx Supporting Statement A	2020-04-20

IC Document Collections

IC ID	Document Title	Status
5503	Application for Department of Defense Common Access Card - DEERS Enrollment Form	Modified

ICR Details

OMB Control No: 0704-0415	ICR Reference No: 202003-0704-008
Status: Active	Previous ICR Reference No: 201701-0704-003
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Application for Identification Card/DEERS Enrollment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/22/2020
	Date Received in OIRA: 03/20/2020
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	04/30/2020
Responses	3,700,000	0	3,700,000
Time Burden (Hours)	185,000	0	185,000
Cost Burden (Dollars)	3,848,000	0	3,848,000

---

Abstract: This information collection requirement is necessary to validate eligibility for all individuals applying for DoD benefits and privileges. These benefits and privileges include but are not limited to, medical coverage, DoD identification cards, access to DoD installations, buildings or facilities, and access to DoD computer systems and networks. This information collection is required to obtain the necessary data elements to determine eligible individual's benefits and privileges, to provide a proper identification card reflecting those benefits and privileges, and to maintain a centralized database of the eligible population.

---

Authorizing Statute(s): PL: Pub.L. 106 - 65 373 Name of Law: null
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 3041	01/17/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 16088	03/20/2020
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Department of Defense Common Access Card - DEERS Enrollment	DD 1172-2	Application for Identification Card/DEERS Enrollment

---

ICR Summary of Burden

	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	3,700,000	3,700,000	0	0	0	0
Annual Time Burden (Hours)	185,000	185,000	0	0	0	0
Annual Cost Burden (Dollars)	3,848,000	3,848,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $2,175,800

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/20/2020

---