PARENTS DEPENDENCY AFFIDAVIT

ICR 197807-0704-001

OMB: 0704-0010

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
108380 Migrated
ICR Details
0704-0010 197807-0704-001
Historical Active 197506-0704-002
DOD/DODDEP
PARENTS DEPENDENCY AFFIDAVIT
Extension without change of a currently approved collection   No
Regular
Approved without change 08/16/1978
Retrieve Notice of Action (NOA) 07/12/1978
  Inventory as of this Action Requested Previously Approved
06/30/1981 06/30/1981 06/30/1978
12,000 0 12,720
36,000 0 38,160
0 0 0

IN COMPLIANCE WITH DEPENDENCE ACT OF 1950, FINANCIAL INFORMATION IS NEEDED TO SCREEN APPLICANTS FOR DEPENDENT ASSISTANCE. IF THE APPLICANT MEETS THE REQUIREMENT OF THE ACT, ASSISTANCE IS PROVIDED.

None
None


No

1
IC Title Form No. Form Name
PARENTS DEPENDENCY AFFIDAVIT DD137-3

  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 12,000 12,720 0 0 -720 0
Annual Time Burden (Hours) 36,000 38,160 0 0 -2,160 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
07/12/1978


© 2024 OMB.report | Privacy Policy