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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Forms Relating to Military Service Records
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
36 CFR 1228.164
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NA 13036
Authorization for Release of Military Medical Patient Records
NA 13036_08FINAL.doc
http://www.archives.gov/st-louis/military-personnel/public/medical-records-veterans-access.html
Yes
No
Fillable Printable
Form and Instruction
NA 13055
Request for Information Needed to Reconstruct Medical Data
NA 13055_08FINAL.doc
http://www.archives.gov/st-louis/military-personnel/alternate-record-sources.html
Yes
No
Fillable Printable
Form and Instruction
NA 13075
Questionnaire about Military Service
NA 13075_08FINAL.doc
http://www.archives.gov/st-louis/military-personnel/alternate-record-sources.html
Yes
No
Fillable Printable
Form and Instruction
NA 13042
Request for Information Needed to Locate Medical Records
NA 13042 Request for Information Needed to Locate Medical Records_02_10.doc
http://www.archives.gov/st-louis/military-personnel/other-medical-records.html
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Cultural and Historic Preservation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
79,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
79,800
0
0
0
0
79,800
Annual IC Time Burden (Hours)
6,650
0
0
0
0
6,650
Annual IC Cost Burden (Dollars)
0
0
0
0
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.