Information Collection

Request for Examination

IC 190096 under ICR 200907-0704-001 · OMB 0704-0468.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0468 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 680-3A-E Request for Examination	Form
680-3A-E Request for Examination USMEPCOM Form 680-3A-E.pdf	Form

IC Title:

Request for Examination

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	680-3A-E	Request for Examination	USMEPCOM Form 680-3A-E.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: A0601-270 USMEPCOM DoD

FR Citation: 70 FR 9284

Number of Respondents: 850,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	850,000	850,000
Annual IC Time Burden (Hours)	141,950	141,950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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