Information Collection

Forms Relating to Civilian Service Records

IC 32540 under ICR 201301-3095-001 · OMB 3095-0037.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3095-0037 can be found here:

Documents and Forms

Document Name Document Type
Form NA Form 13022 Forms Relating to Civilian Service Records Form and Instruction
NA Form 13022 Returned Request Form NA Form 13022final_1_13.docx www.archives.gov/st-louis/civilian-personnel/NA13022.pdf Form and Instruction
NA Form 13064 Reply to Request Involving Relief Agencies NA Form 13064final_1_13.doc www.archives.gov/st-louis/civilian-personnel/NA13064.pdf Form and Instruction
NA Form 13068 Walk-In Request for OPM Records or Information NA Form 13068final_1_13.doc www.archives.gov/st-louis/civilian-personnel/NA13068.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Forms Relating to Civilian Service Records	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 1228.164

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA Form 13022	Returned Request Form	NA Form 13022final_1_13.docx	http://www.archives.gov/st-louis/civilian-personnel/NA13022.pdf	Yes	No	Printable Only
Form and Instruction	NA Form 13064	Reply to Request Involving Relief Agencies	NA Form 13064final_1_13.doc	http://www.archives.gov/st-louis/civilian-personnel/NA13064.pdf	Yes	No	Printable Only
Form and Instruction	NA Form 13068	Walk-In Request for OPM Records or Information	NA Form 13068final_1_13.doc	http://www.archives.gov/st-louis/civilian-personnel/NA13068.pdf	Yes	No	Printable Only

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32,060	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	32,060	32,060
Annual IC Time Burden (Hours)	2,671	2,671
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.