United States Navy Illicit Behavior Screening Certificate

ICR 200208-0703-001

OMB: 0703-0052

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0703-0052 200208-0703-001
Historical Active
DOD/NAVY
United States Navy Illicit Behavior Screening Certificate
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/06/2002
Retrieve Notice of Action (NOA) 08/16/2002
This collection is cleared for a period of one year. During this year, DoD will address use of a common DoD form by all services for screening illicit behavior and providing certification regard ing same.
  Inventory as of this Action Requested Previously Approved
12/31/2003 12/31/2003
65,000 0 0
13,000 0 0
0 0 0

Used by Navy Recruiting to screen applicant's for history of alcohol abuse, drug abuse, and other illicit behaviors. This information is used in determining acceptability for Naval service. Respondents are individuals interested in entering military service.

None
None


No

1
IC Title Form No. Form Name
United States Navy Illicit Behavior Screening Certificate NAVCRUIT-1133/, 65

  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 65,000 0 0 65,000 0 0
Annual Time Burden (Hours) 13,000 0 0 13,000 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.
08/16/2002


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