Application for the Review of Discharge from the Armed Forces of the United States

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 293 Application for the Review of Discharge from the Armed Forces of the United States	Form	Modified	Available
PIA Sections 1-2.pdf	Supplementary Document	Uploaded 2014-10-21	Available
SSN Justification - signed.pdf	Supplementary Document	Uploaded 2014-10-20	Available
Supporting Statement - 0704-0004_FINAL.docx	Supporting Statement A	Uploaded 2014-10-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5237	Application for the Review of Discharge from the Armed Forces of the United States	Form	Modified

ICR Details

OMB Control No: 0704-0004	ICR Reference No: 201410-0704-010
Status: Historical Active	Previous ICR Reference No: 201109-0704-008
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Application for the Review of Discharge from the Armed Forces of the United States
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: 12/01/2014
	Date Received in OIRA: 10/27/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	36 Months From Approved	12/31/2014
Responses	10,000	0	8,000
Time Burden (Hours)	7,500	0	6,000
Cost Burden (Dollars)	54,375	0	69,800

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Abstract: Under Title 10 USC 1553 and DOD Directive 1332.41, "Boards for the Correction of Military Records (BCMRs) and Discharge Review Board (DRBs)," former service members who received an administrative discharge have the right to appeal the characterization or reason for separation provided they do so within 15 years from the date of separation. The DD Form 293, "Application for Review of Discharge or Separation from the Armed Forces of the United States," is the form that allows former Service members to explain the reasons for the alleged error, designate legal counsel, and provides DRBs nevessary information to process requests.

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Authorizing Statute(s): US Code: 10 USC 1553 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 49287	08/20/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 63906	10/27/2014
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
Application for the Review of Discharge from the Armed Forces of the United States	DD Form 293	Application for the Review of Discharge from the Armed Forces of the US.

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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	10,000	8,000	0	0	2,000	0
Annual Time Burden (Hours)	7,500	6,000	0	0	1,500	0
Annual Cost Burden (Dollars)	54,375	69,800	0	0	-15,425	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: The increase in respondent labor burden is due to an anticipated increase in the number of individuals using the form. The decreased cost burden is due to a more efficient way of handling the forms.

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Annual Cost to Federal Government: $18,466,000

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: 10/27/2014

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