Disposition of Remains - Reimbursable Basis Request for Payment of Funeral and/or Internment Expenses

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 1375 Disposition of Remains - Reimbursable Basis Request for Payment of Funeral and/or Interment Expenses	Form	Modified	Available
0704-0030 Supporting Statement Part A Dec 15.DOCX	Supporting Statement A	Uploaded 2016-02-08	Available
DOD 1300_22_Oct_2015.PDF	Supplementary Document	Uploaded 2016-02-08	Available
SSN JUSTIFICATION.PDF	Supplementary Document	Uploaded 2016-02-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5249	Disposition of Remains - Reimbursable Basis Request for Payment of Funeral and/or Interment Expenses	Form	Modified

ICR Details

OMB Control No: 0704-0030	ICR Reference No: 201602-0704-001
Status: Historical Active	Previous ICR Reference No: 200608-0704-003
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Disposition of Remains - Reimbursable Basis Request for Payment of Funeral and/or Internment Expenses
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/25/2016
	Date Received in OIRA: 02/08/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved
Responses	2,450	0	0
Time Burden (Hours)	1,224	0	0
Cost Burden (Dollars)	12,985	0	0

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Abstract: DD Form 2065 records disposition instuctions and costs for preparation and final disposition of remains. DD Form 1375 provides the person authorized to direct disposition (PADD) an instrument to apply for reimbursement of funeral/interment expenses. This information is used to adjudicate and pay claims submitted by the PADD.

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Authorizing Statute(s): US Code: 5 USC 301 Name of Law: Departmental Regulations
   US Code: 5 USC 552(a) Name of Law: Public information, agency rules, opinions, orders, records and proceedings
   US Code: 10 USC 1482(b) Name of Law: Expenses incident to death
   US Code: 10 USC 1485(b) Name of Law: Dependents of members of armed forces
   US Code: 10 USC 1486(b)-1486-(c) Name of Law: Other citizens of United States
   US Code: 10 USC 3013 Name of Law: Secretary of the Army
   US Code: 10 USC 5013 Name of Law: Secretary of the Navy
   US Code: 10 USC 5041(d) Name of Law: Marine Corps Function
   US Code: 10 USC 8013 Name of Law: Secretary of the Air Force
   US Code: 44 USC 3101-3102, 3501 Name of Law: Public Printing and Documents
  

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 59140	10/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 6243	02/05/2016
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
Disposition of Remains - Reimbursable Basis Request for Payment of Funeral and/or Interment Expenses	DD Form 1375, DD Form 2065	Request for Payment of Funeral and/or Interment Expenses ,   Disposition of Remains - Reimburseable Basis

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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	2,450	0	0	-750	0	3,200
Annual Time Burden (Hours)	1,224	0	0	674	0	550
Annual Cost Burden (Dollars)	12,985	0	0	12,985	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: There is a change in burden because this is a reinstatement of a previously approved collection.

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Annual Cost to Federal Government: $1,887,038

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: 02/08/2016

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