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OMB Control No: 0704-0425	ICR Reference No: 202604-0704-003
Status: Received in OIRA	Previous ICR Reference No: 202303-0704-007
Agency/Subagency: DOW/DODDEP	Agency Tracking No:
Title: Application for Department of Defense Impact Aid for Children with Severe Disabilities
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 05/27/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2026
Responses	100	150
Time Burden (Hours)	350	401
Cost Burden (Dollars)	22,284	14,650

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	100	150	-50
Annual Time Burden (Hours)	350	401	-51
Annual Cost Burden (Dollars)	22,284	14,650	7,634

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Respondent burden has increased due to an increase in Local Educational Agencies' salary.

Annual Cost to Federal Government: $7,300

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. No

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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