View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0703-0076	ICR Reference No: 201911-0703-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOW/NAVY	Agency Tracking No: 0703-AALN
Title: Consent to Release Personal Information
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/16/2019
	Date Received in OIRA: 11/15/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2022	36 Months From Approved
Responses	2,000	0	0
Time Burden (Hours)	1,300	0	0
Cost Burden (Dollars)	34,054	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	2,000	2,000
Annual Time Burden (Hours)	1,300	1,300
Annual Cost Burden (Dollars)	34,054	34,054

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: This is a new collection with a new associated burden.

Annual Cost to Federal Government: $40,635

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

Agency Contact: Kira Starks 571 372-4529 danikquia.k.starks.ctr@mail.mil

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