Exchange Employee and Retirement Benefit System

Forms and Documents

Document Name	Status
Form Exchange Form 1700 Beneficiary Designation (Exchange Form 1700-012) Form and Instruction	Unchanged
Form Exchange Form 1450 Annuity Application (Exchange Form 1450-011) Form and Instruction	Unchanged
0702-0139_DRAFT PIA_Exchange Personnel Systems.pdf Supplementary Document	2025-12-28
SORN - AAFES 0703.07 (DRAFT) - AAFES EMPLOYEE PAY SYSTEM RECORDS.pdf Supplementary Document	2022-09-30
0702-0139_SSN Justification_2.1.2024.pdf Supplementary Document	2025-12-28
0702-0139_SSA_12.29.2025.docx Supporting Statement A	2025-12-28

IC Document Collections

IC ID	Document Title	Status
222966	Beneficiary Designation (Exchange Form 1700-012) Form and Instruction	Unchanged
222963	Annuity Application (Exchange Form 1450-011) Form and Instruction	Unchanged
222952	Web-based Health/Benefit Enrollment Other-Website	Modified

ICR Details

OMB Control No: 0702-0139	ICR Reference No: 202512-0702-002
Status: Received in OIRA	Previous ICR Reference No: 202209-0702-002
Agency/Subagency: DOD/DOA	Agency Tracking No:
Title: Exchange Employee and Retirement Benefit System
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/30/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	10,530	10,530
Time Burden (Hours)	3,510	3,510
Cost Burden (Dollars)	122,534	122,534

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Abstract: This information collection allows the Army and Air Force Exchange Service (AAFES) to administer pay, health insurance, life insurance, and retirement benefits for its current employees, retirees, and their families. The collection is necessary to enroll new employees in benefit programs, process changes, and ensure that retirees and their designated beneficiaries receive correct and timely annuity payments. Most employees manage their benefits online through the secure e-Benefits portal. However, paper forms are also available for retirees and for certain legally required actions, such as applying for retirement annuities. This process is essential for AAFES to manage its employee benefits system effectively and fulfill its obligations to its workforce

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Authorizing Statute(s): US Code: 42 USC 659 Name of Law: Consent by United States to income withholding, garnishment, and similar proceeding for enforcement
   US Code: 10 USC 7013 Name of Law: Secretary of the Army
   US Code: 10 USC 9013 Name of Law: Secretary of the Air Force
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 43586	09/10/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 60689	12/29/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Annuity Application (Exchange Form 1450-011)	Exchange Form 1450-011	Annuity Application
Beneficiary Designation (Exchange Form 1700-012)	Exchange Form 1700-012	Beneficiary Designation
Web-based Health/Benefit Enrollment

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ICR Summary of Burden

	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	10,530	10,530	0	0	0	0
Annual Time Burden (Hours)	3,510	3,510	0	0	0	0
Annual Cost Burden (Dollars)	122,534	122,534	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,507,840

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/30/2025

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