Application for Former Spouse Payments from Retired Pay

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 2293 Application for Former Spouse Payments from Retired Pay	Form	Modified	Available
10 USC, Section 1408.pdf	Supplementary Document	Uploaded 2013-08-01	Available
SORN - T7347b.docx	Supplementary Document	Uploaded 2013-08-01	Available
SORN - T7335f.docx	Supplementary Document	Uploaded 2013-08-01	Available
SORN - T7320.docx	Supplementary Document	Uploaded 2013-08-01	Available
SORN - T5500b.docx	Supplementary Document	Uploaded 2013-08-01	Available
SSN Justification.pdf	Supplementary Document	Uploaded 2013-07-19	Available
Supporting Statement 2013 - FINAL (8-1-13).doc	Supporting Statement A	Uploaded 2013-08-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5635	Application for Former Spouse Payments from Retired Pay	Form	Modified

ICR Details

OMB Control No: 0730-0008	ICR Reference No: 201307-0730-001
Status: Historical Active	Previous ICR Reference No: 200712-0730-001
Agency/Subagency: DOD/DFAS	Agency Tracking No:
Title: Application for Former Spouse Payments from Retired Pay
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/10/2013
	Date Received in OIRA: 08/01/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved
Responses	29,127	0	0
Time Burden (Hours)	7,282	0	0
Cost Burden (Dollars)	164,276	0	0

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Abstract: The informatio nfrom the DD Form 2293 is used to process the applicant's request for direct payments as authorized under Title 10 U.S.C. Section 1408. The DD Form 2293 was devised to provide for a uniform method for applicants to submit the required information. Information on the form is also used to determine the applicant's current status and contains the statutory required certifications the applicant/former spouse must make when applying for payments.

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Authorizing Statute(s): US Code: 10 USC 1408 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 6091	02/07/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 44551	07/24/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for Former Spouse Payments from Retired Pay	DD Form 2293	Application for Former Spouse Payments From Retired Pay

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	29,127	0	0	0	2,037	27,090
Annual Time Burden (Hours)	7,282	0	0	0	510	6,772
Annual Cost Burden (Dollars)	164,276	0	0	0	164,276	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a reinstatement with change of a previously approved collection. Total burden hours have increased from 6,722 to 7,282 based on increased number of respondents.

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Annual Cost to Federal Government: $955,074

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/01/2013

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