View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0703-0068
ICR Reference No:
202011-0703-001
Status:
Historical Active
Previous ICR Reference No:
201709-0703-001
Agency/Subagency:
DOD/NAVY
Agency Tracking No:
Title:
USMC Children, Youth and Teen Programs (CYTP) Registration Packet
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/06/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/02/2020
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2024
36 Months From Approved
01/31/2021
Responses
112,000
0
112,000
Time Burden (Hours)
131,040
0
131,040
Cost Burden (Dollars)
2,320,640
0
2,320,640
Abstract:
The information collected on these forms is used by MFP and Inclusion Action Team (IAT) professionals for purposes of patron registration, to determine the general health status of patrons participating in CYTP activities and if necessary the appropriate accommodations for the patron for full enjoyment of CYTP services, and provides consent for information to be exchanged between MFP personnel and other designated individuals or organizations about a patron participating in MFP.
Authorizing Statute(s):
US Code:
10 USC 5013
Name of Law: Secretary of the Navy
US Code:
10 USC 5041
Name of Law: Headquarters, Marine Corps
US Code:
10 USC 88, Subch. II
Name of Law: Military Family Programs and Military Child Care: Military Child Care
EO: EO 9397 Name/Subject of EO: SSN
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
85 FR 56592
09/14/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 77454
12/02/2020
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
USMC Children, Youth and Teen Programs (CYTP) Registration Packet
NAVMC 1750/4, NAVMC 11720, NAVMC 1750/5
USMC Children, Youth & Teen Programs Registration Form
,
USMC FAMILY CARE PROGRAMS CONSENT TO RELEASE INFORMATION
,
USMC Children, Youth & Teen Programs (CYTP) Health Assessment
ICR Summary of Burden
Total Approved
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
112,000
112,000
0
0
0
0
Annual Time Burden (Hours)
131,040
131,040
0
0
0
0
Annual Cost Burden (Dollars)
2,320,640
2,320,640
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$1,182,820
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?
No
Agency Contact:
Kira Starks 571 372-4529 danikquia.k.starks.ctr@mail.mil
Common Form ICR:
No
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:
12/02/2020
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