Information Collection

Application for Department of Defense Common Access Card - DEERS Enrollment

IC 5503 under ICR 200710-0704-007 · OMB 0704-0415.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0415 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 1172-2 Application for Department of Defense Common Access Card - DEERS Enrollment	Form
DD Form 1172-2 Application for Department of Defense Common Access Card 0704-0415 Draft dd1172-2.pdf	Form
0704-0415 DEPSEC memo 11-10-99.pdf Smart Card Adoption and Implementation	IC Document
0714-0415 ASD-C3I Memo 8-12-00.pdf Department of Defense Public Key Infrastructure	IC Document
0704-0415 USD PR - DOD CIO Memo 4-18-02.pdf Common Access Card - Changes	IC Document
0704-0415 HSPD-12.pdf Homeland Security Presidential Directive/HSPD-12	IC Document

IC Title:

Application for Department of Defense Common Access Card - DEERS Enrollment

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 1172-2	Application for Department of Defense Common Access Card - DEERS Enrollment	0704-0415 Draft dd1172-2.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: DMDC 02 - Defense Eligibility Records

FR Citation: 72 FR 55757

Number of Respondents: 300,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	300,000	0	300,000
Annual IC Time Burden (Hours)	50,000	-50,000	100,000
Annual IC Cost Burden (Dollars)	2,304,000	2,304,000	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Smart Card Adoption and Implementation	0704-0415 DEPSEC memo 11-10-99.pdf	10/24/2007
Department of Defense Public Key Infrastructure	0714-0415 ASD-C3I Memo 8-12-00.pdf	10/24/2007
Common Access Card - Changes	0704-0415 USD PR - DOD CIO Memo 4-18-02.pdf	10/24/2007
Homeland Security Presidential Directive/HSPD-12	0704-0415 HSPD-12.pdf	10/24/2007

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