Exceptional Family Member Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 2792 Exceptional Family Member Program	Form and Instruction	Modified	Available
DDES.pdf	Supplementary Document	Uploaded 2014-06-17	Available
SSN Memo - 2792-1-signed.pdf	Supplementary Document	Uploaded 2014-06-17	Repair queued
SSN Memo - 2792-signed.pdf	Supplementary Document	Uploaded 2014-06-17	Available
Supporting Statement Part A 0704-0411_Final.doc	Supporting Statement A	Uploaded 2014-06-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5496	Exceptional Family Member Program	Form and Instruction	Modified

ICR Details

OMB Control No: 0704-0411	ICR Reference No: 201406-0704-002
Status: Historical Active	Previous ICR Reference No: 201101-0704-002
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Exceptional Family Member Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/24/2014
	Date Received in OIRA: 06/23/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	07/31/2014
Responses	44,555	0	43,332
Time Burden (Hours)	20,072	0	19,460
Cost Burden (Dollars)	648,903	0	672,513

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Abstract: This information collection requirement is necessary to screen members of military families to determine if they have special medical (DD Form 2792) and/or educational (DD Form 2792-1) conditions so that these conditions can be taken into consideration when the Service member is being assigned to a new location with his/her family. The information is used by the personnel system to identify special considerations for future assignments.

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Authorizing Statute(s): US Code: 20 USC 1400 Name of Law: null
   US Code: 20 USC 921 Name of Law: null
   PL: Pub.L. 94 - 191 all 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:
	79 FR 114	01/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 35535	06/23/2014
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
Exceptional Family Member Program	DD Form 2792-I, DD Form 2792	Family Member Medical Summary ,   Special Education/Early Intervention Summary

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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	44,555	43,332	0	0	1,223	0
Annual Time Burden (Hours)	20,072	19,460	0	0	612	0
Annual Cost Burden (Dollars)	648,903	672,513	0	0	-23,610	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: It is estimated that the number of respondents will increase.

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Annual Cost to Federal Government: $504,247

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: 06/23/2014

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