Information Collection

Request for DLA Badge

IC 210666 under ICR 201403-0704-003 · OMB 0704-0511.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DLA 1815 Request for DLA Badge	Form
PAS AGENCY DISCLOSURE NOTICE for DL1815.docx	Other-PAS & ADN
DLA 1815 Request for DLA Badge DLA 1815.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	DLA 1815	Request for DLA Badge	DLA 1815.pdf		No		Paper Only
Other-PAS & ADN			PAS AGENCY DISCLOSURE NOTICE for DL1815.docx		No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: Facility Access Records

FR Citation: 74 FR 22896

Number of Respondents: 15,000

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	3,750	3,750
Annual IC Cost Burden (Dollars)	93,435	93,435

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.