Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States

ICR 200408-0704-001

OMB: 0704-0100

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0704-0100 200408-0704-001
Historical Active 200108-0704-003
DOD/DODDEP
Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States
Extension without change of a currently approved collection   No
Regular
Approved without change 10/26/2004
Retrieve Notice of Action (NOA) 08/24/2004
  Inventory as of this Action Requested Previously Approved
10/31/2007 10/31/2007 10/31/2004
3,000 0 3,000
1,500 0 1,500
0 0 2,000

38 USC 106 amends (PL 95-202, Sec 401) directs Secretary of Defense to determine if civilian employment or contractual service rendered by groups to the Armed Forces of the United States shall be considered active duty. Using DD Form 2168, "Application for Discharge of Member of the Group Certified to Have Performed Active Duty with the Armed Forces of the U.S., "this information collection provides data necessary to assist each Military Department in determining if an applicant was a member of a group which performed active military service. Individuals recognized as a member of an approved group are.....

None
None


No

  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 3,000 3,000 0 0 0 0
Annual Time Burden (Hours) 1,500 1,500 0 0 0 0
Annual Cost Burden (Dollars) 0 2,000 0 0 -2,000 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.
08/24/2004


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