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OMB Control No: 0704-0588	ICR Reference No: 202605-0704-003
Status: Received in OIRA	Previous ICR Reference No: 202209-0704-004
Agency/Subagency: DOW/DODDEP	Agency Tracking No: 0704-AABZ
Title: PFPA Recruitment, Medical, and Fitness Forms
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 05/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	3,600	0
Time Burden (Hours)	520	0
Cost Burden (Dollars)	13,920	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	3,600	3,600
Annual Time Burden (Hours)	520	520
Annual Cost Burden (Dollars)	13,920	13,920

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 reinstatement without change of a previously approved collection.

Annual Cost to Federal Government: $314,027

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: Dajonte Holsey 703 571-2939 dajonte.l.holsey.civ@mail.mil

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