Confirmation of Reasonable Accommodation Request

Department of the Navy (DON) Reasonable Accommodations (RA) Tracker

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0063 can be found here:

Documents and Forms

Document Name Document Type
Form SECNAV 12306/1T Confirmation of Reasonable Accommodation Request Form
SECNAV 12306/1T Confirmation of Reasonable Accommodation Request SECNAV 12306_1T - RA_FINAL (1010).PDF Form

Information Collection (IC) Details

IC Title:	Confirmation of Reasonable Accommodation Request	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SECNAV 12306/1T	Confirmation of Reasonable Accommodation Request	SECNAV 12306_1T - RA_FINAL (1010).PDF		Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Strategic National and Theater Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	1,543	1,543

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.