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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Defense Sexual Assault Incident Database
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
DD 2965
Defense Sexual Assault Incident Database (DSAID) Data Form
dd2965_20150824.pdf
Yes
Yes
Fillable Printable
Form
DD 2910
Victim Reporting Preference Statement
dd2910_20151103.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
DHRA 06 Defense Sexual Assault Incident Database
FR Citation:
79 FR 38534
Number of Respondents:
1,130
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
25 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,130
0
0
-2,070
0
3,200
Annual IC Time Burden (Hours)
1,313
0
0
-1,887
0
3,200
Annual IC Cost Burden (Dollars)
29,640
0
0
29,640
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.