DLA Energy Request for Customer QR Code

Forms and Documents

Document Name	Status
Form DLA Form 2063 DLA Energy Request for Customer QR Code Form and Instruction	Modified
DoDM 4140.25-v10.PDF Supplementary Document	2025-08-27
DLA Energy P-29.PDF Supplementary Document	2025-08-27
0704-0640_SSA_11.13.25.docx Supporting Statement A	2025-11-13

IC Document Collections

IC ID	Document Title	Status
254951	DLA Energy Request for Customer QR Code Form and Instruction	Modified

ICR Details

OMB Control No: 0704-0640	ICR Reference No: 202508-0704-007
Status: Received in OIRA	Previous ICR Reference No: 202207-0704-010
Agency/Subagency: DOD/DODDEP	Agency Tracking No: 0704-DLQR
Title: DLA Energy Request for Customer QR Code
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/03/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,782	0
Time Burden (Hours)	2,782	0
Cost Burden (Dollars)	122,909	0

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Abstract: All activities that purchase fuel from DLA Energy including DoD, Federal Agencies, Federal Contractors, and Non-US Government Entities with a fuel purchase agreement with DLA Energy can request a Customer QR code. The code is another form of Authorized Purchase Source Media (APSM) used to buy petroleum and aerospace products from DLA Energy.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 37474	08/05/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 50745	11/10/2025
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
DLA Energy Request for Customer QR Code	DLA Form 2063	DLA Energy Request for Customer QR Code

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ICR Summary of Burden

	Total Request	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	2,782	0	0	2,052	0	730
Annual Time Burden (Hours)	2,782	0	0	2,052	0	730
Annual Cost Burden (Dollars)	122,909	0	0	94,768	0	28,141

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The number of responses has increased due to the current number of Vehicle Purchase Media Managers (VPMMs). In addition, the wages have increased to match the current year’s numbers. In result, this has increased the burden.

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Annual Cost to Federal Government: $61,454

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.     No

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.     No

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? No

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Common Form ICR:  No

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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: 12/03/2025

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