DD Form 397 SUPPORTING STATEMENT

SUPPORTING STATEMENT

Claim Certification and Voucher for Death Gratuity Payment (DD Form 397)

A. Justification

1. This information collection allows the government to collect the signatures and information needed to pay a death gratuity. Pursuant to 10 U.S.C. 1475 – 1480, a designated beneficiary(ies) or next-of-kin can receive a death gratuity payment for a deceased service member. This form serves as a record of the disbursement of the death gratuity. The DoD Financial Management Regulation (FMR), Volume 7A, Chapter 36, defines the eligible beneficiaries and procedures for payment of the death gratuity. To provide internal controls for this benefit, and to comply with the above-cited statutes, the information requested is needed to substantiate the receipt of the benefit.

2. The Service Casualty Office completes the upper portion of the DD Form 397 and then provides the form to the beneficiaries. The beneficiaries complete their portion of the DD Form 397 and then sign the form and have it witnessed. The Service Casualty Office fills out the lower part of the form with the required administrative information. Once the documents are completed they are forwarded to DFAS for payment.

3. The DD Form 397 is available in fillable PDF format from the DoD Forms Repository on the World Wide Web. The Casualty Office can complete their portion of the form on-line and print the form to take in-person or mail to the beneficiaries. The Department of Defense requires signatures and hard copies of these documents. Thus, currently, there is no cost-effective way to apply information technology to this collection process.

4. No similar information or verification procedures exist within the Department of Defense which can be used for this specific purpose.

5. No small businesses or other entities are significantly impacted by this information collection.

6. If this collection were not done, it would prevent the DoD from providing the death gratuity payment in a manner consistent with federal internal control requirements.

7. There are no special circumstances. The collection of information will be conducted in a manner consistent with the guidelines in 5 CFR 1320.5(d)(2).

8. A 60 day Federal Register notice was published for this form on December 28, 2007, Vol. 72, No. 248. Copy attached. No comments were received.

9. No payments or gifts will be provided to the respondents, other than payment paid as benefits resulting from meeting eligibility requirements.

10. The forms state “Routine Uses” indicating who may be furnished information as required by the Privacy Act. The Defense Finance and Accounting Service certifies that the information collected is maintained in accordance with the Privacy Act of 1974, and OMB Circular A-130, Management of Information Resources and FIRMR Bulletin B-1. The SSN and other identifying information for the beneficiaries and witnesses are needed to pay the proper person, ensure entitlement to benefits, and for tax purposes. Without the SSN identifying information, payments of death gratuities to beneficiaries could not be processed. The information collected on this form is covered under Privacy Act System of Records Notice DFAS T7340, Defense Joint Military Pay System – Active Component.

11. There are no questions of a sensitive nature, such as those pertaining to sexual behavior and attitudes, religious beliefs, and other matters usually considered private.

12. (a) Respondent Burden:

Responses Per Respondent: 1

Number of Respondents: 2,416

Response Time: .5 hours

Annual Burden: 1,208 hours

(b) Respondent Costs:

Cost to each respondent involves about .5 hours of time for completion of

each form for a total cost of $27,675 based on a GS-8 hourly wage ($22.91 x .5 hours x 2,416 responses). The cost of postage is negligible.

13. There are no capital or start-up costs associated with this information collection. Postage costs are negligible.

14. The estimated annualized cost associated with government review totals $28,907.44.

Printing: 2,416 forms per year @ $0.10 = $241.60

Mailing: 2,416 forms per year @ $0.41 = $990.56

Processing: GS-8 hourly wage of $22.91 x .5 hours x 2,416 = $27,675.28

15. Program change due to an existing collection in use without an OMB Control Number.

16. Results of the collection of information will not be published.

17. Approval is not sought for avoiding display of the expiration date for OMB approval of the information collection.

18. There are no exceptions to the certification statement identified in Item 19, “Certification for Paperwork Reduction Act Submission,” of OMB Form 83-I.

B. Collections of Information Employing Statistical Methods

The collection of information does not employ statistical methods.