0730-0017_ss-a_05.27.2021

SUPPORTING STATEMENT – PART A

Claim Certification and Voucher for Death Gratuity – OMB No. 0730-0017

JUSTIFICATION

1.  Need for the Information Collection

This collection allows the government to collect the signatures and information needed to pay a death gratuity. Pursuant to the 10 U.S.C. 1475, “Death Gratuity: Death of Members on Active Duty or Inactive Duty Training and of Certain Other Persons,” 10 U.S.C. 1476, “Death Gratuity: Death After Discharge or Release from Active Duty or Training,” 10 U.S.C. 1477, “Death Gratuity: Eligible Survivors,” 10 U.S.C. 1478, “Death Gratuity: Amount,” 10 U.S.C. 1479, “Death Gratuity: Delegation of Determinations, Payments,” 10 U.S.C. 1480, “Death Gratuity: Miscellaneous Provisions,” a designated beneficiary(ies) or next-of-kin can receive a death gratuity payment for a deceased service member. This form serves as a record of the disbursement of death gratuity. The DoD Financial Management Regulation (FMR), Volume 7A, Chapter 36, “Military Pay Policy and Procedures Active Duty and Reserve Pay,” defines the eligible beneficiaries and procedures for payment of the death gratuity. To provide internal controls for this benefit, and to comply with the above cited statutes, the information requested is needed to substantiate the receipt of the benefit.

2.  Use of the Information

Service Casualty Officers use personnel and service records to identify death gratuity beneficiary (ies). Service Casualty Officer retrieves and completes the upper portion of the DD Form 397, Claim Certification and Voucher for Death Gratuity. The form is printed and either taken in-person or mailed to the beneficiary (ies). Beneficiary (ies) complete their portion of the form, sign and have it witnessed. They can return through the Casualty Officer or by mail as directed on the form. Upon receipt, Service Casualty Officer completes administration portion of the form and forwards for processing.

The finance office, or DFAS MPO (depending on Service procedures) reviews the form and makes payment using a voucher and service specific disbursing system. If there is a question as to whom the correct beneficiary is, or when the beneficiary is a minor, Defense Finance and Accounting Services (DFAS) reviews the DD Form 93, Record of Emergency Data, and processes payments. For all deaths within 120 days after a retirement, DFAS Retired and Annuitant Pay will make the payments.

The form is available on the DoD Forms website (https://www.esd.whs.mil/Directives/forms/). The Privacy Act Statement and Agency Disclosure Notice are available to the respondent on the form.

3.  Use of Information Technology

0% electronic submissions received. The Casualty Officer completes their portion of the form on-line and prints the form to take in-person or mail to beneficiary (ies). Due to the need for wet signatures of respondents and witnesses, there is no cost-effective way to apply information technology to this collection process.

4.  Non-duplication

The information obtained through this collection is unique and is not already available for use or adaptation from another cleared source.

5.  Burden on Small Business

This information collection does not impose a significant economic impact on a substantial number of small businesses or entities.

6.  Less Frequent Collection

If this collection were not done, it would prevent the DoD from providing the death gratuity payment in a manner consistent with federal internal control requirements.

7.  Paperwork Reduction Act Guidelines

This collection of information does not require collection to be conducted in a manner inconsistent with the guidelines delineated in 5 CFR 1320.5(d)(2).

8.  Consultation and Public Comments

Part A: PUBLIC NOTICE

A 60-day Federal Register Notice for the collection published on Wednesday, January 6, 2021. The 60-day FRN citation is 86 FRN 531.

A 30-day Federal Register Notice for the collection published on June, 16, 2021. The 30-day FRN citation is 86 FRN 26707.

Part B: CONSULTATION

No additional consultation apart from soliciting public comments through the 60-day Federal Register Notice was conducted for this submission.

9.  Gifts or Payment

No payments or gifts are being offered to respondents as an incentive to participate in the collection.

10.  Confidentiality

Respondents are notified of their rights via the Privacy Act Statement on the form. The DFAS certifies that the information collected is maintained in accordance with the Privacy Act of 1974 and OMB Circular A-130, Management of Information Resources and Federal Information Resources Management Regulation (FIRMR) Bulletin B-1. System of Record Notices (SORNs) for this form:

T7340, Defense Joint Military Pay System – Active Component (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570191/t7340/)

T7344, Defense Joint Military Pay System – Reserve Component: (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570195/t7344/)

M01040-3, Marine Corps Total Force System: (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570625/m01040-3/)

T7205b, Stanfins Redesign Subsystem (SRD-1) (used by Air Force and Army): (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/1099368/t7205b/ )

Central Disbursing System (CDS) (used by Air Force): The SORN is in the process of being completed.

T7906, Automated Disbursing System (used by Navy and Marine Corps): (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570203/t7906/ )

Privacy Impact Assessments (PIAs) for this form are located at https://www.dfas.mil/foia/privacyimpactassessments.html, except for the Marine Corps Total Force System, available at http://www.doncio.navy.mil/uploads/Summary_USMC_TFDW_PIA_11-29-2011.pdf

Records Retention:

T7340, Defense Joint Military Pay System – Active Component: Records may be temporary in nature and destroyed when actions are completed, superseded, obsolete, or no longer needed. Other records may be cut off at the end of the payroll year or fiscal year, and destroyed 6 years and 3 months after cutoff. Active duty pay records created prior to automation were cut off on conversion to the Defense Joint Military Payroll System (DJMS), and will be destroyed October 1, 2033 or 56 years after implementation of DJMS. The records are destroyed by tearing, shredding, pulping, macerating, burnings or degaussing the electronic storage media.

T7344, Defense Joint Military Pay System – Reserve Component: Records may be temporary in nature and destroyed when actions are completed, superseded, obsolete, or no longer needed. Other records may be cut off at the end of the payroll year or fiscal year, and destroyed 6 years and 3 months after cutoff. Reserve pay records created prior to automation were cut off on conversion to the Joint Uniformed Military Payroll System (JUMPS), and will be destroyed 56 years after the year in which created. Records created after conversion to Defense Joint Military Pay System – Reserve Component (DJMS-RC) are cut off at end of payroll year and destroyed 56 years after year in which created. The records are destroyed by tearing, shredding, pulping, macerating, burnings or degaussing the electronic storage media.

M01040-3, Marine Corps Total Force System: Disposition pending (until the National Archives and Records Administration approves retention and disposal schedule, records will be treated as permanent).

T7205b, Stanfins Redesign Subsystem (SRD-1) (used by Air Force and Army): Records are maintained in a controlled facility. Physical entry is restricted by the use of locks, guards, and is accessible only to authorized personnel. Access to records is limited to person(s) responsible for servicing the record in performance of their official duties and who are properly screened and cleared for need-to-know. Access to computerized data is restricted by passwords, which are changed according to agency security policy. Cut off at end of fiscal year. Destroy 6 years, 3 months after the later of either closure of appropriate account or liquidation of all obligations in the closed account. Records are disposed of by degaussing, burning, tearing, recycling, melting, chemical decomposition, pulping, pulverizing, shredding, mutilation, overwriting, and incineration.

Central Disbursing System (CDS) (used by Air Force): The SORN is in the process of being completed.

T7906, Automated Disbursing System (used by Navy and Marine Corps): Records are stored in a building protected by guards, controlled screening, use of visitor registers, electronic access, and/or locks. Access to records is limited to individuals who are properly screened and cleared on a need-to-know basis in the performance of their duties.  Passwords are used to control access to the system data, and procedures are in place to detect and deter browsing and unauthorized access. Records are temporary in nature, cut off at the end of the fiscal year and destroyed 6 years and 3 months after cutoff. Records are destroyed by degaussing, burning, of shredding.

11.  Sensitive Questions

The Social Security Number (SSN) of the member is required for processing transactions in legacy systems. The lack of an SSN would create a risk that improper payments could be made to ineligible individuals and the Disbursing or Certifying Officer could not verity the payment as required in 31 U.S.C. 3528. An approved justification memo is being submitted as part of the OMB package.

12.  Respondent Burden, and its Labor Costs

a.  Estimation of Respondent Burden

Estimation of Respondent Burden Hours
	Number of Respondents	Number of Responses per Respondent	Number of Total Annual Responses	Response Time	Respondent Burden Hours
DD 397, Claim Certification and Voucher for Death Gratuity	500	1	500	.5 hours (30 minutes)	250 hours
Total	500		500		250 hours

b.  Labor Cost of Respondent Burden

Labor Cost of Respondent Burden
	Number of Responses	Response Time per Response	Respondent Hourly Wage *	Labor Burden per Response	Total Labor Burden
DD 397, Claim Certification and Voucher for Death Gratuity	500	.5 hours (30 minutes)	$7.25	$3.625	$1,812.50
Total	500		$7.25	$3.625	$1,812.50

*The respondent hourly wage was determined by using the Federal minimum wage for 2021 at: https://www.dol.gov/general/topic/wages/minimumwage).

13.  Respondent Costs Other than Burden Hour Costs

2.5% of respondents mail the form back to the government. 500 x 2.5% x postage = $6.13 annual cost.

14.  Cost to the Federal Government

	DD 397, Claim Certification and Voucher for Death Gratuity	Total
Number of Responses	500	500
Processing Time Per Response (in hours)	.5 hour (30 minutes)	.5
Hourly Wage of Worker(s) Processing Responses (Federal Civil Service 2020 Pay Structure) *	$23.23	$23.23
Cost to Process Each Response	$11.615	$11.615
Total Cost to Process Responses	$5,807.50	$5,807.50

Operational and Maintenance Costs
Equipment	Printing	Postage*	Software Purchases	Licensing Costs	Other	Total
	$50.00					$56.13

Total Cost to the Federal Government
Operational and Maintenance Costs	Labor Cost to the Federal Government	Total Cost
$56.13	$4,800	$4,856.13

15.  Reasons for Change in Burden

This is an extension with no change to an approved collection. There was a slight increase in Federal costs due to an adjusted estimate for

16.  Publication of Results

The results of this information collection will not be published.

17.  Non-Display of OMB Expiration Date

We are not seeking approval to omit the display of the expiration date of the OMB approval on the collection instrument.

18.  Exceptions to "Certification for Paperwork Reduction Submissions"

We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.

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