Information Collection

Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court

IC 5649 under ICR 200709-0730-001 · OMB 0730-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0730-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 137-3 Dependency Statement - Parent Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court	Form
Form DD Form 137-4 Dependency Statement - Child Born Out Of Wedlock Under Age 21 Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court	Form
Form DD Form 137-5 Dependency Statement - Incapacitated Child Under Age 21 Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court	Form
Form DD Form 137-6 Dependency Statement - Full Time Student 21-22 Years of Age Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court	Form
Form DD Form 137-7 Dependency Statement - Ward of Court Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court	Form
DD Form 137-3 Dependency Statement - Parent dd0137-3_draft.pdf	Form
DD Form 137-4 Dependency Statement - Child Born Out Of Wedlock Under A dd0137-4_draft.pdf	Form
DD Form 137-5 Dependency Statement - Incapacitated Child Under Age 21 dd0137-5_draft.pdf	Form
DD Form 137-6 Dependency Statement - Full Time Student 21-22 Years of dd0137-6_draft.pdf	Form
DD Form 137-7 Dependency Statement - Ward of Court dd0137-7_draft.pdf	Form
DoDFMR Vol 7A, Ch 26.pdf DoD 7000.14-R, Vol 7A	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Dependency Statements: Parent, Child Born Out of Wedlock, Incapacitated Child Over Age 21, Full Time Student 21-22 Years of Age, and Ward of a Court

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 137-3	Yes	No	Fillable Printable
Form	DD Form 137-4	Yes	No	Fillable Printable
Form	DD Form 137-5	Yes	No	Fillable Printable
Form	DD Form 137-6	Yes	No	Fillable Printable
Form	DD Form 137-7	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19,440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 16 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	19,440	0	19,440
Annual IC Time Burden (Hours)	24,300	0	24,300
Annual IC Cost Burden (Dollars)	484,299	484,299	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DoD 7000.14-R, Vol 7A		09/28/2007

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

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