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Application for a Review by the Physical Disability Board of Review
Application for a Review by the Physical Disability Board of Review
OMB: 0704-0453
IC ID: 187660
OMB.report
DOD/DODDEP
OMB 0704-0453
ICR 201003-0704-014
IC 187660
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0453 can be found here:
2021-07-14 - Reinstatement with change of a previously approved collection
2012-12-11 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form DD Form 294
Application for a Review by the Physical Disability Board of Review
Form
DD Form 294 Application for a Review by the Physical Disability Boar
Draft-DD294.pdf
Form
F036 SAFCB A.doc
Air Force SORN
IC Document
A0015-185 SFMR.doc
Army SORN
IC Document
N01850-2.doc
Navy SORN
IC Document
NM01000-1.doc
Navy SORN
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for a Review by the Physical Disability Board of Review
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
DD Form 294
Application for a Review by the Physical Disability Board of Review
Draft-DD294.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
850
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
850
0
0
-950
0
1,800
Annual IC Time Burden (Hours)
638
0
0
-712
0
1,350
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Air Force SORN
F036 SAFCB A.doc
12/23/2008
Army SORN
A0015-185 SFMR.doc
12/23/2008
Navy SORN
N01850-2.doc
12/23/2008
Navy SORN
NM01000-1.doc
12/23/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.