View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0704-0580	ICR Reference No: 202108-0704-006
Status: Historical Active	Previous ICR Reference No: 201809-0704-003
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Exceptional Family Member Program (EFMP) Family Needs Assessment
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: 03/15/2022
	Date Received in OIRA: 01/28/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2025	36 Months From Approved	03/31/2022
Responses	20,000	0	20,000
Time Burden (Hours)	10,000	0	10,000
Cost Burden (Dollars)	270,800	0	271,800

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	20,000	20,000	0
Annual Time Burden (Hours)	10,000	10,000	0
Annual Cost Burden (Dollars)	270,800	271,800	-1,000

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: $95,800

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: LaTarsha Yeargins 571 372-2089 latarsha.r.yeargins.ctr@mail.mil

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