Claim Certification and Voucher for Death Gratuity Payment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0730-0017 can be found here:

Documents and Forms

Document Name Document Type
Form DD Form 397 Claim Certification and Voucher for Death Gratuity Payment Form
DD Form 397 Claim Certification and Voucher for Death Gratuity Payme dd397_20171027.pdf www.esd.whs.mil/Directives/forms/dd0001_0499/ Form
DD Form 397 Claim Certification and Voucher for Death Gratuity Payme dd397_20171027.pdf www.esd.whs.mil/Directives/forms/dd0001_0499/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claim Certification and Voucher for Death Gratuity Payment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 397	Claim Certification and Voucher for Death Gratuity Payment	dd397_20171027.pdf	https://www.esd.whs.mil/Directives/forms/dd0001_0499/	Yes	No	Printable Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title: T7340 Defense Joint Military Pay System-Active Component	FR Citation: 71 FR 14179

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	1,813	1,813

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.