Information Collection

Application For Discharge Of Member Or Survivor Of Member Of Group Certified To Have Performed Active Duty With The Armed Forces Of The United States

IC 108661 under ICR 199110-0704-001 · OMB 0704-0100.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0100 can be found here:

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	APPLICATION FOR DISCHARGE OF MEMBER OR SURVIVOR OF MEMBER OF GROUP CERTIFIED TO HAVE PERFORMED ACTIVE DUTY WITH THE ARMED FORCES OF THE UNITED STATES	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	DD 2168				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000	-2	1,002
Annual IC Time Burden (Hours)	500	-100	600
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.