Exchange Employee Management and Pay System

ICR 201909-0702-001

OMB: 0702-0139

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Removed
Form and Instruction
Modified
Supplementary Document
2019-09-19
Supplementary Document
2019-09-19
Supplementary Document
2019-09-19
Supporting Statement A
2019-09-19
ICR Details
0702-0139 201909-0702-001
Active 201608-0702-001
DOD/DOA
Exchange Employee Management and Pay System
Extension without change of a currently approved collection   No
Regular
Approved without change 10/24/2019
Retrieve Notice of Action (NOA) 09/19/2019
  Inventory as of this Action Requested Previously Approved
10/31/2022 36 Months From Approved 10/31/2019
10,530 0 7,650
3,483 0 2,533
94,050 0 63,333

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

  84 FR 23531 05/22/2019
84 FR 45472 08/29/2019
No

3
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
Web-based "Health/Benefit Enrollment" (eBenefits)
Exchange Form 1450-018 Exchange Form 1450-018 Application for Payment of Survivor Annuity

  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 10,530 7,650 0 2,880 0 0
Annual Time Burden (Hours) 3,483 2,533 0 950 0 0
Annual Cost Burden (Dollars) 94,050 63,333 0 30,717 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Burden changed due to updated burden numbers

$4,495,576
No
    Yes
    Yes
No
No
No
Uncollected
Reginald Lucas 571 372-0403 reginald.t.lucas2.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.
09/19/2019


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