Exceptional Family Member Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0411 can be found here:

Documents and Forms

Document Name Document Type
Form DD Form 2792 Exceptional Family Member Program Form and Instruction
DD Form 2792 Family Member Medical Summary DD Form 2792.pdf Form and Instruction
DD Form 2792-I Special Education/Early Intervention Summary DD Form 2792-1.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Exceptional Family Member Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD Form 2792	Family Member Medical Summary	DD Form 2792.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DD Form 2792-I	Special Education/Early Intervention Summary	DD Form 2792-1.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44,555	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 30 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44,555	1,223	43,332
Annual IC Time Burden (Hours)	20,072	612	19,460
Annual IC Cost Burden (Dollars)	648,903	-23,610	672,513

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.