OMB CONTROL NUMBER: 0702-XXXX
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0702-XXXX, is estimated to average 18 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 the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. 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.
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 1475, Death gratuity: death of members on active duty or inactive duty training and of certain other persons; 10 U.S.C. 7013, Secretary of the Army; Army Regulation 608-1, Army Community Service, DoDI 1300.18, Department of Defense (DoD) Personnel Casualty Matters, Policies, and Procedures; Army Regulation (AR) 638-8, Army Casualty Program; AR 638-2, Army Mortuary Affairs Program.
PURPOSE: The purpose of the information system is to collect surviving member information when seeking program assistance for Fallen Soldiers benefits. This module is utilized by Active Duty Army, Army Reserve, National Guard survivor outreach service program personnel for client intake. The information system also has the capability to generate analytical reports which are provided to higher headquarters as needed.
ROUTINE USES: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3).
DISCLOSURE: Voluntary. However, failure to provide the requested information may impede Army Community Service personnel from being able to assist individuals effectively.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | The following is a sample Agency Disclosure Notice: |
Author | Patricia Toppings |
File Modified | 0000-00-00 |
File Created | 2021-07-29 |