Information Collection

Request For Certification Of Military Or Naval Service

IC 119251 under ICR 199108-1115-001 · OMB 1115-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1115-0022 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	REQUEST FOR CERTIFICATION OF MILITARY OR NAVAL SERVICE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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	N-426				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	32,000	25,000	7,000
Annual IC Time Burden (Hours)	5,312	4,150	1,162
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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