DoD Consolidated Adjudications Facility Request for Records

ICR 201912-0704-002

OMB: 0704-0561

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2019-12-17
Supplementary Document
2019-12-17
Supporting Statement A
2019-12-19
IC Document Collections
IC ID
Document
Title
Status
224416 Modified
ICR Details
0704-0561 201912-0704-002
Active 201611-0704-002
DOD/DODDEP
DoD Consolidated Adjudications Facility Request for Records
Extension without change of a currently approved collection   No
Regular
Approved without change 01/23/2020
Retrieve Notice of Action (NOA) 12/19/2019
  Inventory as of this Action Requested Previously Approved
01/31/2023 36 Months From Approved 01/31/2020
120 0 120
10 0 10
232 0 232

The information collection requirement is necessary to ensure needed information is collected to positively identify individuals who request records regarding themselves are maintained by the DoD Consolidated Adjudications Facility.

US Code: 5 USC 552a Name of Law: null
   US Code: 10 USC 113 Name of Law: null
   EO: EO 9397 Name/Subject of EO: null
  
None

Not associated with rulemaking

  84 FR 57017 10/24/2019
84 FR 69730 12/19/2019
No

1
IC Title Form No. Form Name
DoD CAF Form 3: Request for Records DoD CAF Form 3 Request for Records

  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 120 120 0 0 0 0
Annual Time Burden (Hours) 10 10 0 0 0 0
Annual Cost Burden (Dollars) 232 232 0 0 0 0
No
No

$11,369
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.
12/19/2019


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