AF FORM 1984 STUDENT'S DEPENDENCY STATEMENT

ICR 198904-0701-002

OMB: 0701-0109

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
107952 Migrated
ICR Details
0701-0109 198904-0701-002
Historical Active 198602-0701-004
DOD/AF
AF FORM 1984 STUDENT'S DEPENDENCY STATEMENT
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 05/30/1989
Retrieve Notice of Action (NOA) 04/03/1989
  Inventory as of this Action Requested Previously Approved
05/31/1992 05/31/1992
900 0 0
900 0 0
0 0 0

FORM ARE USED TO OBTAIN INFORMATION TO VERIFY DEPENDENCY OF COLLEGE STUDENT UPON SERVICE MEMBER, RETIRED MEMBER, OR SURVIVING SPOUSE FOR ENTITLEMENT TO ID CARE PRIVILEGES.

None
None


No

1
IC Title Form No. Form Name
AF FORM 1984 STUDENT'S DEPENDENCY STATEMENT AF 1984

  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 900 0 0 900 0 0
Annual Time Burden (Hours) 900 0 0 900 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
04/03/1989


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