2014 05 07 - DTRA Form(s) 150 - Supporting Statement B

SUPPORTING STATEMENT – PART B

DTRA Form(s) 150

1.  Description of the Activity

The Defense Threat Reduction Agency (DTRA) is a Department of Defense (DoD) combat support agency that serves as executive agent for the Nuclear Test Personnel Review (NTPR) Program. The NTPR Program serves military personnel and DoD civilian employees who participated in U.S. atmospheric nuclear testing (1945-1962), with the occupation forces of Hiroshima and Nagasaki, Japan, or were prisoners of war in Japan at the conclusion of World War II. The NTPR Program assists these military and civilian participants, supports the Department of Veterans Affairs (VA) and Department of Justice (DOJ) in responding to radiogenic disease compensation claims, and provides information to organizations responsible for studies concerning the health effects of ionizing radiation. For DTRA to fulfill this role, it must collect information from veterans and former DoD civilian employees. DTRA Forms 150, 150-A, 150-B, and 150-C serve as the collection vehicle.

No sampling method is used to collect information from affected individuals. DTRA procedure for employing DTRA Forms(s) 150:

Form 150 (Information Request and Release): Employed by DTRA to verify identity of requester of information and to obtain signature of affected individual (or authorized representative) in order to release information to an authorized representative.

Form 150-A (Questionnaire for Continental United States Test Participants): Employed by DTRA to collect radiation exposure scenario information from an individual who has submitted a radiogenic disease claim to the VA (38 CFR 3.311), based on their participation in a continental United States atmospheric nuclear test detonation. DTRA uses this information to perform an individualized radiation dose assessment for the VA and the individual.

Form 150-B (Questionnaire for Oceanic Test Participants): Employed by DTRA to collect radiation exposure scenario information from an individual who has submitted a radiogenic disease claim to the VA (38 CFR 3.311), based on their participation in an oceanic atmospheric nuclear test detonation. DTRA uses this information to perform an individualized radiation dose assessment for the VA and the individual.

Form 150-C (Questionnaire for CROSSROADS Test Participants): Employed by DTRA to collect radiation exposure scenario information from an individual who has submitted a radiogenic disease claim to the VA (38 CFR 3.311), based on their participation in Operation CROSSROADS in July 1946. DTRA uses this information to perform an individualized radiation dose assessment for the VA and the individual.

DTRA Collection Vehicle	Annual Responses
Form 150	120
Form 150-A	118
Form 150-B	168
Form 150-C	84

Note, expected and actual response rate is approximately 95%. Total respondents (370) is a sum of Forms 150-A, -B, and –C, since Form 150 is only sent to Form-A, -B, and –C respondents who have not previously provided this information to DTRA or VA.

2.  Procedures for the Collection of Information

Describe any of the following if they are used in the collection of information:

a.  Statistical methodologies for stratification and sample selection: Not applicable.

b.  Estimation procedures: Not applicable.

c.  Degree of accuracy needed for the Purpose discussed in the justification: Degree of accuracy is based on veteran’s memory of radiation exposure scenario.

d.  Unusual problems requiring specialized sampling procedures: Not applicable.

e.  Use of periodic or cyclical data collections to reduce respondent burden: Not applicable.

3.  Maximization of Response Rates, Non-response, and Reliability

The data collection process is primarily by paper forms mailed to the participant. DTRA’s mailing to the participant includes a franked, self-addressed envelope for return mailing of the completed form. If forms are not returned in thirty days, NTPR Program staff contact the respondent by phone to assist them. Once a form is returned and the respondent's case completed, additional consultation is not required.

4.  Tests of Procedures: Not applicable.

5.  Statistical Consultation and Information Analysis: Not applicable.

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