Information Collection

Selective Service Record Request

IC 202205 under ICR 201205-3095-004 · OMB 3095-0071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3095-0071 can be found here:

Documents and Forms

Document Name Document Type
Form NA Form 13172 Selective Service Record Request Form
NA Form 13172 Selective Service Record Request na-13172.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Selective Service Record Request	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA Form 13172	Selective Service Record Request	na-13172.docx		No		Printable Only

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,200	3,200
Annual IC Time Burden (Hours)	107	107
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.