Information Collection

DD Form 619

IC 213157 under ICR 201409-0704-001 · OMB 0704-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 619 DD Form 619	Form
DD Form 619 Statement of Accessorial Services Performed DD 619 DRAFT.pdf	Form

IC Title:

DD Form 619

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	DD Form 619	Statement of Accessorial Services Performed	DD 619 DRAFT.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: 876

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	227,760	227,760
Annual IC Time Burden (Hours)	18,980	18,980
Annual IC Cost Burden (Dollars)	294,190	294,190

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.