Exchange Official Personnel Folder - Privilege Card

Forms and Documents

Document Name	Status
Form Exchange Form 1100 Identification and Privilege Card Application Form and Instruction	New
SSN MEMO- PMIS.PDF Supplementary Document	2015-11-18
SSN MEMO- OPF.PDF Supplementary Document	2015-11-18
SORN DRAFT - PMIS (0903 06).docx Supplementary Document	2015-11-18
SORN DRAFT - OPF (0401 04).docx Supplementary Document	2015-11-18
Reference Links (Active).docx Supplementary Document	2015-11-18
PIA - PUBLISHED - OPF AND PMIS(PORTRAIT).pdf Supplementary Document	2015-11-18
Supporting Statement A (04 NOV 15).docx Supporting Statement A	2015-11-18

IC Document Collections

IC ID	Document Title	Status
219006	Identification and Privilege Card Application Form and Instruction	New

ICR Details

OMB Control No: 0702-0129	ICR Reference No: 201511-0702-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/DOA	Agency Tracking No:
Title: Exchange Official Personnel Folder - Privilege Card
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/21/2015
	Date Received in OIRA: 11/18/2015
Terms of Clearance: This collection is approved based on the revised materials provided by the Department. DOD must report this collection as a violation in the ICB.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved
Responses	2,500	0	0
Time Burden (Hours)	625	0	0
Cost Burden (Dollars)	4,525	0	0

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Abstract: Dependents and Exchange Retirees wishing to obtain or maintain status as an Exchange authorized patron for shopping privileges submit applications for an approved patronage card.

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Authorizing Statute(s): EO: EO 9397 Name/Subject of EO: SSN
   US Code: 10 USC 3013 Name of Law: Secretary of the Army
   US Code: 10 USC 8013 Name of Law: Secretary of the Air Force
  

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:
	80 FR 869	01/07/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 72052	11/17/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Identification and Privilege Card Application	DD Form 2574, Exchange Form 1100-016	Army & Air Force Exchange Service Identification & Privilege Card Application ,   Dependent Card

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ICR Summary 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	2,500	0	0	2,500	0	0
Annual Time Burden (Hours)	625	0	0	625	0	0
Annual Cost Burden (Dollars)	4,525	0	0	4,525	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is an existing collection in use without an OMB Control number.

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Annual Cost to Federal Government: $76,026

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: 11/18/2015

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