View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0702-0152	ICR Reference No: 202112-0702-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOW/DOA	Agency Tracking No: 0702-SACA
Title: Application for Survivor Access Card
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: 01/31/2022
	Date Received in OIRA: 12/28/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2025	36 Months From Approved
Responses	670	0	0
Time Burden (Hours)	670	0	0
Cost Burden (Dollars)	4,858	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	670	670
Annual Time Burden (Hours)	670	670
Annual Cost Burden (Dollars)	4,858	4,858

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: $23,551

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: Nicholas Schuff 757 817-7203 nicholas.a.schuff.ctr@mail.mil

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