SMART Scholarship Award Length Change Approval

Award Length Change Approval
AUTHORITY: 10 U.S.C. 2192a, Science, Mathematics, and Research for Transformation (SMART) Defense Education Program; 5 U.S.C. 3304, Competitive
service examinations; 20 U.S.C. 17, National Defense Education Program; and E.O. 9397 (SSN), as amended.
PRINCIPLE PURPOSE(S): To record a SMART Participant’s agreement to either increase/decrease the SMART award length which incurs either an increase or
decrease in their service commitment to the SMART Program.
ROUTINE USES: Disclosure of records are generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended. To academic institutions for
the purpose of providing progress reports for applicants and participants; to consumer reporting agencies as defined in the Fair Credit Reporting Act
(15 U.S.C. 1681a(f)) or the Federal Claims Collection Act of 1966 (31 U.S.C. 3701(a)(3)). The purpose of this disclosure is to aid in the collection of
outstanding debts owed to the Federal government, typically to provide an incentive for debtors to repay delinquent Federal government debts by making
these debts part of their credit records;
Applicable Blanket Routine Use(s) are: Law Enforcement Routine Use, Congressional Inquiries Disclosure Routine Use, Disclosure When Requesting
Information Routine Use, Disclosure of Requested Information Routine Use, Disclosure to the Department of Justice for Litigation Routine Use, Disclosure of
Information to the National Archives and Records Administration Routine Use, and Data Breach Remediation Purposes Routine Use.
The DoD Blanket Routine Uses set forth at the beginning of the Office of the Secretary of Defense (OSD) compilation of systems of records
notices may apply to this system. The complete list of DoD Blanket Routine Uses can be found Online at:
http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx
The applicable Privacy Act System of Records Notice is DUSDA 14, Science, Mathematics, and Research for Transformation (SMART) Information
Management System, found at http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570592/dusda-14.aspx
DISCLOSURE: Mandatory; failure to provide the requested information would result in SMART participant not receiving a SMART award length
increase/decrease.

To:
Date:
Dear __________________________,
The SMART Program is in receipt of your request dated ______________ to increase/decrease your award length by ___.___
years. As agreed upon in Section 5 of the SMART Service Agreement Amendment request dated ______________, you
understood that any approved award length increase incurs an additional service commitment. The Program has approved the
request under the following terms:
The increase/decrease of ___.___ years of academic pursuit constitutes an increase/decrease in the service
commitment period of ___.___ years. The full amount of your service commitment period is ___.___ years.
Please note your acceptance or rejection of these terms by checking the appropriate box and signing below:
 I accept these terms and acknowledge this document constitutes an amendment to the terms of my Service Agreement dated
______________.
 I do not accept these terms.
Printed Name: _____________________________________
Signature: _____________________________________
Date: _____________________________________
The approved request will not be executed by the Program until a signed acceptance is received. If you do not accept
these terms, your request will not be executed by the Program. Failure to timely obtain the degree for which you
received funding may result in your termination from the Program and the prompt repayment of any and all funds
expended by the U.S. Government under your award.
Agency Disclosure Notice
The public reporting burden for this collection of information is estimated to average 2 hours and 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the
Department of Defense, Washington headquarters Services, Executive Services Directorate, Directives Division, 4800 Mark Center Drive, East Tower, Suite
02G09, Alexandria, VA 22350-3100 OMB Control Number: 0704-0466. Respondents should be aware that notwithstanding any other provisions of law, no
person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

OMB No.
OMB approval expires