USMEPCOM 680-3 Supporting Statement

SUPPORTING STATEMENT

A. JUSTIFICATION

1. Need for Information Collection

Title 10 USC, Sections 504, 505, 508, 12102; Title 14 USC, Sections 351 and 632 require applicants to meet standards for enlistment into the Armed Forces. The USMEPCOM Form 680-3A-E “Request for Examination” is used only in the accessions community and is required to properly process and identify an individual requesting an examination at a Military Entrance Processing Station (MEPS). The data provided by the applicant is used to determine eligibility for qualification and eventual enlistment in the Armed Forces and is also the basis for completion of the DD Form 1966, “Record of Military Processing-Armed Forces of the United States.”(OMB Control Number 0704-0173) The USMEPCOM Form 680-3A-E is used as a Privacy Act instrument and personal information release form to obtain medical records release authority from the applicant and to complete the applicant’s biometric enrollment at first contact.

2. Use of Information

The purpose of this information collection is to gather the necessary verifiable information for determining eligibility to process, qualify and join the Armed Forces and for establishing personal records on those enlisting. USMEPCOM Form 680-3A-E “Request for Examination” is the form associated with this information collection.

The USMEPCOM Form 680-3A-E guides the applicant through the qualification process and is the genesis for validating the quality of personnel information. The form is completed by the applicant and assisted by a Service recruiter after an oral interview and before the applicant completes any portion of the qualification process (aptitude, medical, and conduct standards) mandated by DoD and the sponsoring Service.

The information collected on the USMEPCOM Form 680-3A-E is transferred electronically into the DD Form 1966, “Record of Military Processing-Armed Forces of the United States” at time of service acceptance for enlistment. These transfers of data reduce the processing time of DD Form 1966 from 20 minutes to approximately 10 minutes. The form also serves as security verification and processing checklist during MEPS processing.

3. Improved Information Technology

The USMEPCOM Form 680-3A-E is appropriate for electronic generation. This reduces the burden to respondents and to recruiters as well. MEPS have loaded the form into the MEPCOM Integrated Resource System (MIRS) to enable the respondents the ability to electronically complete this form. Once completed, the information on the USMEPCOM Form 680-3A-E is transferred electronically into the DD 1966 and helps reduce administration time during the applicant’s enlistment process.

4. Efforts to Identify Duplication

A review by USMEPCOM and military recruiting representatives resulted in no findings of duplicate reporting or records. No similar information or verification procedure exists that can be used for this information collection.

Data collected on USMEPCOM Form 680-3A-E provides a wide range of information needed to establish eligibility for qualification and enlistment in the Armed Forces. No culmination of data from other sources would provide the necessary information for qualification and enlistment.

5. Methods Used to Minimize Burden on Small Entities

Small businesses and other small entities will not be affected by this collection.

6. Consequences of Not Collecting the Information

Information is collected only once per applicant. If collection were stopped, ability to make determinations for qualification and enlistment into the military would be hindered.

7. Specials Circumstances

This information collection is not conducted under special circumstances. The information is used for none other than qualification and enlistment purposes by the Department of Defense. No requirements are placed on the respondent after providing the information and the personal information collected is kept confidential to the qualification process and the individual’s military records.

8. Agency 60-Day Federal Register Notice and Consultations Outside the Agency

The 60-day Federal Register Notice announcing this information collection (as required by 5 CFR 1320.8(d)) was published on September 15, 2008, Volume 73, Number 179, pages 53208-53209. No comments were received in response to this collection.

The USMEPCOM Form 6803A-E was reviewed by a Core Review Board composed of the following members: LTC Philip Jussel – Staff Judge Advocate, Mr. Ted Daniels – Chief, Accession Division, MAJ Ricardo Bravo – Plans and Operations Officer, Mr. Tom Buehring - Sr. Mgt Analyst, Mr. Glenn Winston - Sr. Mgt Analyst, Mr. Michael McCarrier - Plans Officer/Mgt Analyst/Overseas Testing Mgr, SFC Jaime Clayton - Testing Standards Manager and, Mr. Michael Long - Team Lead, MEPCOM Operations Center. This information was briefed by the Joint Forms Committee to members of the Defense Accession Data Systems Integration Working Group (DADSIWG) on 13 January 2009. The Joint Forms Committee approved this form for electronic generation.

9. Payments to Respondents

No payments, gifts or guarantees are made to respondents who provide this information.

10. Assurance of Confidentiality

Respondents are advised that statements will be held in strictest confidence. Forms maintained in personnel records are seen only by individuals who have a need to verify information contained on therein. A privacy act statement is contained on the form.

All applicants are required to sign privacy act statements before collecting or providing personal information. Services have Systems of Records Notices that permit the collection of data from the public for recruiting purposes. Appropriate Systems of Records Notices for military systems that are tied to applicant processing are provided.

11. Sensitive Questions

Data on race or ethnicity are required to be tracked by each Service for demographic analysis. Religious preference information is voluntary, but is requested to determine the proper mix of chaplains in each Service. Marital status is used to determine appropriate pay and benefits. It also is used to determine the number of dependents, obligations and financial suitability of the applicant and to determine employment eligibility. Responses regarding gender also are requested to determine the total number of male and female applicants. Social Security Number is requested to ensure accuracy of data on the specified individual applicant. The USMEPCOM Form 680-3A-E is the genesis for the personnel record, the medical record, and the security records. The Social Security Number (SSN) is obtained and stored into the initial record (personnel, finance, medical, and security) for proofing, vetting, and maintaining unambiguous person identity for U.S. persons. With the SSN being used for person identification in major DOD human resource systems (personnel, finance, and medical), it remains the only unique identifier that ensures accuracy across all the systems to ensure proper data retrieval.

The USMEPCOM Staff Judge Advocate conducted a review of the form and reported no issues, objections or comments.

12. Estimates of Annual Response Burden and Labor Cost for Hour Burden to the Respondent for Collection of Information

a. Response Burden:

(1) USMEPCOM Form 680-3A-E

Total annual respondents: 850,000
Frequency of response: 1

Total annual response: 850,000
Burden per response: .167 (10 min)
Total burden hours: 141,950

b. Explanation of How Burden was Estimated:

A burden estimate of 10 minutes (.167) is taken to complete the USMEPCOM Form 680-3A-E. This is estimated by having a recruiter observing and working with an applicant filling out the form.

c. Estimated Labor Cost to Respondents.

850,000 respondents x $18.00/hr* @ .167 (10 min) Per form = $2,555,100

*E-5/E-7 estimated hourly rate with inflation.

13. Estimates of Cost Burden for the Respondent for Collection of Information

a. Total Capital and Start-up Costs. There are no capital or start-up costs associated with this collection.

b. Operational and Maintenance Costs. There are no operational or maintenance costs associated with this information collection.

14. Estimates of Cost to the Federal Government

a. Work Load Requirements for USMEPCOM Form 680-3A-E.

1. E5 -E7 recruiter processes form. Estimated completion time is 10 minutes.

2. GS-05/Step 05 reviews items to determine completeness of the responses. Estimated completion time is 5 minutes.

b. Estimated costs for USMEPCOM Form 680-3A-E:

1. E-5/E-7 hourly pay = $18.00 @ 10 min each form (.167) $3.00
2. Printing the form @ .10 per form $ .10
3. Cost to the Federal Government per respondent $3.10

Total costs for USMEPCOM Form 680-3A-E (850,000 X $3.10) $2,635,000

15. Changes in Burden

Since there is no current OMB license, data on burden hours is new.

16. Publication Plans/Time Schedule

Results of this information collection will not be published.

17. Approval Not to Display Expiration Date

Approval not to display the expiration date is not being sought.

18. Exceptions to the Certification Statement

No exceptions to the certification statement are being sought.

B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS

Statistical methods are not employed for this collection of information.