Exchange Employee Management and Pay System

ICR 201608-0702-001

OMB: 0702-0139

Federal Form Document

Forms and Documents
ICR Details
0702-0139 201608-0702-001
Historical Active
DOD/DOA
Exchange Employee Management and Pay System
Existing collection in use without an OMB Control Number   No
Regular
Approved without change 09/12/2016
Retrieve Notice of Action (NOA) 08/11/2016
DOD must report this collection in the Information Collection Budget (ICB).
  Inventory as of this Action Requested Previously Approved
09/30/2019 36 Months From Approved
7,650 0 0
2,533 0 0
63,333 0 0

The Army and Air Force Exchange Service (Exchange) is a Non-Appropriated Fund (NAF) Instrumentality of the United States of America. This information collection is required to process and administer a number of different benefits available to eligible Exchange employees, former employees (retirees), their dependents, beneficiaries, spouses, and ex-spouses. The data collected allows for the accurate and timely processing of all pay, salary, health, retirement, annuities, and beneficiary funds by the Exchange Human Resources (HR) offices and the Finance & Accounting Treasury Benefits department.

US Code: 10 USC 3013 Name of Law: null
   US Code: 10 USC 8013 Name of Law: null
   US Code: 42 USC 659 Name of Law: null
  
None

Not associated with rulemaking

  81 FR 15511 03/23/2016
81 FR 53127 08/11/2016
No

4
IC Title Form No. Form Name
Excahange Form 1450-011 Exchange Form 1450-011 Annuity Application
Exchange Form 1700-012 Exchange Form 1700-012 Beneficiary Designation
Exchange Form 1450-018 Exchange Form 1450-018 Application for Payment of Survivor Annuity
Web-based "Health/Benefit Enrollment" (eBenefits)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 7,650 0 0 7,650 0 0
Annual Time Burden (Hours) 2,533 0 0 2,533 0 0
Annual Cost Burden (Dollars) 63,333 0 0 63,333 0 0
Yes
Miscellaneous Actions
No
This is an information collection that was not previously licensed with an OMB Control symbol.

$4,508,357
No
No
No
No
No
Uncollected
Tyler Robinson 571 372-0403 tyler.f.robinson.ctr@mail.mil

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/11/2016


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