Personnel Accountability and Assessment for a Public Health Emergency

ICR 202103-0720-001

OMB: 0720-0067

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Justification for No Material/Nonsubstantive Change
2021-03-17
Supporting Statement A
2020-10-19
IC Document Collections
ICR Details
0720-0067 202103-0720-001
Received in OIRA 202010-0720-001
DOD/DODOASHA
Personnel Accountability and Assessment for a Public Health Emergency
No material or nonsubstantive change to a currently approved collection   No
Regular 03/17/2021
  Requested Previously Approved
11/30/2023 11/30/2023
100,000 100,000
8,333 8,333
60,000 60,000

The principal purpose of the DD form 3112, “Personnel Accountability and Assessment Notification for a Public Health Emergency,” is to collect information used to protect the health and safety of individuals working in, residing on, or assigned to DoD installations, facilities, field operations, and commands, and to protect the DoD mission.

US Code: 10 USC 2672 Name of Law: Protection of Buildings, Grounds, Property, and Persons
   US Code: 10 USC 113 Name of Law: Secretary of Defense
  
None

Not associated with rulemaking

  85 FR 23509 04/28/2020
85 FR 66314 10/19/2020
No

1
IC Title Form No. Form Name
Personnel Accountability and Assessment for a Public Health Emergency DD Form 3112 Personnel Accountability and Assessment for a Public health Emergency

  Total Request 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 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 8,333 8,333 0 0 0 0
Annual Cost Burden (Dollars) 60,000 60,000 0 0 0 0
No
No

$1,020,500
No
    Yes
    Yes
No
No
No
Yes
Kira Starks 571 372-4529 danikquia.k.starks.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.
03/17/2021


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