0704-0030 Supporting Statement Part A Dec 15X

OMB 0704-0030

DD Form 2065 Disposition of Remains – Reimbursable Basis

DD Form 1375 Request for Payment of Funeral and/or Interment Expenses

SUPPORTING STATEMENT (Refer to OMB Form 83-I INST)

A. JUSTIFICATION

1. Need for the Information Collection

The business need is to support our Service Members and other federal agencies by providing mortuary services, transportation, funeral and interment, support for deceased dependents of our Service Members; and transportation and mortuary service support requested by other federal agencies. In addition, this allows the person authorized to direct disposition of our Service Members remains to be reimbursed for authorized expenses incident to death.

Collection of information is required in response to the following directives and regulations to support the tacking and accountability of personnel:

• 5 USC 301, Departmental Regulations. “Authorizes the head of a military department to prescribe regulations for the government of his department, the conduct of its employees, the distribution and performance of its business, and the custody, use, and preservation of its records, papers, and property.”

• 5 USC 552(a), Public information, agency rules, opinions, orders, records and proceedings. “Outlines Presidential requirements associated to the Freedom of Information Act and disclosure of information.”

• 10 USC 1482(b), Expenses incident to death. “If an individual pays any expense payable by the United States under this section, the Secretary concerned shall reimburse him or his representative in an amount not larger than that normally incurred by the Secretary in furnishing the supply or service concerned. If reimbursement by the United States is also authorized under another provision of law or regulation, the individual may elect under which provision to be reimbursed.” This statute requires the Army to reimburse the survivor for any expenses they paid that the Army, by statute, is required to pay (DD Form 1375).

• 10 USC 1485(b), Dependents of members of armed forces. “The Secretary may furnish mortuary services and supplies, on a reimbursable basis.” When in the best interest of the survivor, the Army will pay for services on a reimbursable basis (DD Form 2065).

• 10 USC 1486(b) Other citizens of United States. “The Secretary may furnish transportation of the remains of persons covered by this section, on a reimbursable basis, to a port of entry in the United States.” When in the best interest of the survivor, the Army will pay for services on a reimbursable basis (DD Form 2065).

• 10 USC 1486(c) Other citizens of United States. “Reimbursement for services, supplies, and transportation furnished under this section shall be collected and credited to appropriations available, at the time of reimbursement, for those services, supplies, and transportation.” When in the best interest of the survivor, the Army will pay for services on a reimbursable basis (DD Form 2065).

• 10 USC 3013, Secretary of the Army. “Subject to the authority, direction, and control of the Secretary of Defense and subject to the provisions of this title, the Secretary of the Army is responsible for, and has the authority necessary to conduct, all affairs of the Department of the Army.”

• 10 USC 5013, Secretary of the Navy. “Subject to the authority, direction, and control of the Secretary of Defense and subject to the provisions of this title, the Secretary of the Navy is responsible for, and has the authority necessary to conduct, all affairs of the Department of the Navy.”

• 10 USC 5041 (d), Marine Corps Function. “Marine Corps, shall be organized in such manner, and its members shall perform such duties and have such titles, as the Secretary of the Navy may prescribe.”

• 10 USC 8013, Secretary of the Air Force. “Subject to the authority, direction, and control of the Secretary of Defense and subject to the provisions of this title, the Secretary of the Air Force is responsible for, and has the authority necessary to conduct, all affairs of the Department of the Air Force.”

• 44 USC 3101-3102, 3501, Public Printing and Documents. “The head of each Federal agency shall make and preserve records containing adequate and proper documentation of the organization, functions, policies, decisions, procedures, and essential transactions of the agency and designed to furnish the information necessary to protect the legal and financial rights of the Government and of persons directly affected by the agency’s activities.”

• Department of Defense Directive, 1300.22

a. The remains of deceased DoD-affiliated or -covered persons, consistent with applicable laws and regulations, who die in military operations, training accidents, or other DoD-related fatality incidents will be recovered, identified, and returned to their families as expeditiously as possible while maintaining the dignity, respect, and care of the deceased to the extent possible and protecting the safety of the living.

b. Mortuary services will be provided on a non-reimbursable or reimbursable basis for eligible personnel pursuant to sections 1481 to1488 and 1490 of Title 10, United States Code (U.S.C.) (Reference (c)) and section 5742 of Title 5, U.S.C.

2. Use of the Information

DD Form 2065 records the sponsor’s disposition instructions for the remains and to record the associated cost for necessary services and supplies. If the remains are shipped to the United States, the sponsor will be required to complete and sign DD Form 2065, selecting one of three options. A signed copy of this form will accompany the remains to the port mortuary. The DD Form 2065 is presented to the sponsor by the Casualty Assistance Officer (CAO) who will aid the sponsor in the completion of the DD Form 2065. Once the form is completed the CAO will return the completed form to Casualty Assistance Center (CAC). The sponsor will then submit payment to the Army budget office by a vehicle of their choosing. The CAC will then upload the DD Form 2065 in the Defense Casualty Information Processing System (DCIPS). The sponsor is typically a Family member of the deceased. The Privacy Act Statement is on the form and this is how respondents are notified of the appropriate disclosures.

The DD Form 1375 is the form on which payment of interment allowance will be requested. The DD Form 1375 is presented to the sponsor by the Casualty Assistance Officer (CAO) who will aid the sponsor in the completion of the DD Form 1375. The sponsor is typically a Family member of the deceased. Once the form is completed the CAO will return the completed form to Casualty Assistance Center (CAC). The claim must be signed by the claimant and include all documents e.g., receipts for services performed or paid for. The Army budget office will then adjudicate the claim and process the payment to the sponsor. The Army budget office will upload the DD Form 1375 claim packet into DCIPS. The Privacy Act Statement is on the form and this is how respondents are notified of the appropriate disclosures.

The SSN, along with other personnel data information, is securely collected, stored, and managed in accordance with DoD 5400.11-R, “Department of Defense Privacy Program” and the Defense Casualty Information Processing System (DCIPS) Systems of Record Notice.

3. Use of Information Technology

Electronic submission is not possible due to the responders are civilians and are required to sign both DD Form 2065 and DD Form 1375. However, once both forms are completed, they are stored in the Defense Casualty Information Processing System.

4. Non-duplication

There is no duplication of the required information collected on either DD Form 2065 or DD Form 1375.

5. Burden on Small Business

There are no burdens placed on any small business as both DD Forms 2065 and DD Form 1375 are completed by individuals and not a small business.

6. Less Frequent Collection

This information is collected occasionally when a death meets the need to collect such information.

7. Paperwork Reduction Act Guidelines

There are no special circumstances to the Paperwork Reduction Act in the completion of the Army’s commitment of caring for the remains of our fallen Soldiers.

8. Consultation and Public Comments

Date of publication of 60 Day Federal Register Notice: Thursday, October 01, 2015

Federal Register Citation: 80 FR 59140

No comments were received.

Date of publication of 30 Day Federal Register Notice: Friday, February 05, 2016

Federal Register Citation: 81 FR 6243

Consultation was completed with the Air Force, Navy and United States Marine Corps to identify the continued requirement to collect the information from the next-of-kin or sponsor to fill-in the reimbursable costs or desired disposition of remains. Without the information on these forms the government would not be able to respond to the survivor's wishes or justify its expenses in handling the deceased.

9. Gifts or Payment

The Army does not provide any incentives for the respondent to complete the DD Form 2065 and DD Form 1375.

10. Confidentiality

All beneficiaries of a deceased servicemember are required to complete a Privacy Act Statement supplied by their casualty assistance service representative. This Privacy Act Statement is then uploaded and stored in the Defense Casualty Information Processing System.

SORN for the Defense Casualty Information Processing System is located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570058/a0600-8-1c-ahrc-dod.aspx

A PIA is not required because PII is not being collected electronically.

Offices having Army-wide responsibility: Records are permanent. Keep in current file area until no longer needed for conducting business, then retire to Records Holding Area (RHA)/Army Electronic Archive (AEA). Transfer a snap shot of the DCIPS Master File to AEA annually at the end of the fiscal year. The AEA will transfer a snap shot of DCIPS to the National Archives and Records Administration (NARA) one year after the signature by the Archivist of the United States. Thereafter, the AEA will transfer a snap shot of DCIPS to NARA every two years. Legal custody of each snap shot will transfer to NARA when the record is 25 years old.

11. Sensitive Questions

DD Forms 2065 and 1375 are initially prepared by military authorities and presented to the next-of-kin or sponsor to fill-in the reimbursable costs or desired disposition of remains. Without the information on these forms the government would not be able to respond to the survivor’s wishes or justify its expenses in handling the deceased. Also available at government expense is transportation of the remains to a port of entry in the United States. Because more than one person may share the same name, accurate retrieval of information through the use of a SSN is the only available method at this time to make and prove an accurate and timely determination concerning the death of an individual and to determine what benefits the decedent’s family may be eligible.

12. Information Collection Hour Burden

Estimation of Respondent Burden Hours
	Number of Respondents	Number of Responses per Respondent	Number of Total Annual Responses	Response Time (Amount of time needed to complete the collection instrument)	Respondent Burden Hours (Total Annual Responses multiplied by Response Time) Please compute these into hours)
Collection Instrument DD Form 2065	2,450	1	2,450	20 minutes	816 hours
Collection Instrument DD Form 1375	2,450	1	2,450	10 minutes	408 hours
Total					1224 hours

Labor Cost of Respondent Burden
	Number of Responses	Response Time per Response	Respondent Hourly Wage Source: Department of Labor	Labor Burden per Response (Response Time multiplied by Respondent Hourly Wage)	Total Labor Burden (Number of Respondents multiplied by Response Time multiplied by Respondent Hourly Wage)
Collection Instrument DD Form 2065	2,450	20 minutes	$10.59	$3.53	$8648.50
Collection Instrument DD Form 1375	2,450	10 minutes	$10.59	$1.77	$4336.50
Total					$12985.00

http://www.bls.gov/news.release/pdf/realer.pdf

13. Respondent Costs Other than Burden Hour Costs

There is no other cost to the respondent in the collection of the required information. DD Form 2065 and DD Form 1375 is hand carried by the Casualty Assistance Officer supporting the respondent.

14. Federal Government Annualized Costs

Labor Cost to the Federal Government
	Collection Instrument DD Form 2065	Collection Instrument DD Form 1375	Total
Number of Responses	2,450	2,450	4,900
Processing Time Per Response (in hours)	20 minutes	10 minutes	30 minutes
Hourly Wage of Worker(s) Processing Responses Source; Office of Personnel Management GS 9 pay scale	$26.37	$26.37	$52.74
Cost to Process Each Response (Processing Time Per Response multiplied by Hourly Wage of Worker(s) Processing Responses)	$8.79	$4.40	$13.19
Total Cost to Process Responses (Cost to Process Each Response multiplied by Number of Responses)	$21,535.50	$10,767.75	$32,303.25

Operational and Maintenance Costs
Equipment	Printing	Postage	Software Purchases	Licensing Costs	Other	Total
0	$735.00	0	0	0	$1,854,000	$1,854,735.00

Total Cost to the Federal Government
Operational and Maintenance Costs	Labor Cost to the Federal Government	Total Cost (O&M Costs + Labor Cost)
$1,854,735.00	$32,303.25	$1,887,038.25

15. Reasons for Change in Burden

There is a change in burden because this is a reinstatement of a previously approved collection.

16. Publication of Results

There is no requirement to publicize any results.

17. Non-Display of OMB Expiration Date

There is no request for a non-display of the OMB expiration date.

18. Exceptions to "Certification for Paperwork Reduction Submissions"

There is no request for an exception to Certification for Paperwork Reduction Submission.