Information Collection

Request for Examination

IC 190096 under ICR 201003-0704-009 · OMB 0704-0468.

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 680-3A-E New Draft.doc	Form

IC Title:

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	680-3A-E	Request for Examination	680-3A-E New Draft.doc		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
	Approved	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.