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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form NA Form 13172 Selective Service Record Request	Form
NA Form 13172 Selective Service Record Request na-13172.docx	Form

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:

table that charts list of 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 %

table that charts list of burden
	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

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.