View Information Collection Request (ICR) Package

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: 0730-0014	ICR Reference No: 202101-0730-001
Status: Historical Active	Previous ICR Reference No: 201712-0730-002
Agency/Subagency: DOD/DFAS	Agency Tracking No: 0730-0014
Title: Dependency Statements: Parent, Incapacitated Child Over Age 21, Full Time Student 21-22, Ward of a Court
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/30/2021
	Date Received in OIRA: 05/18/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2024	36 Months From Approved	06/30/2021
Responses	16,371	0	14,975
Time Burden (Hours)	14,256	0	14,191
Cost Burden (Dollars)	315,640	0	305,527

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	16,371	14,975	1,396
Annual Time Burden (Hours)	14,256	14,191	65
Annual Cost Burden (Dollars)	315,640	305,527	10,113

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: Yes

Burden Reduction Due to: Cutting Redundancy

Short Statement: This submission is an extension with change to an expired collection. The number of respondents were reevaluated and found to have increased.

Annual Cost to Federal Government: $136,861

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: Kellen Stout 317 645-3128 kellen.a.stout.civ@mail.mil

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