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OMB 0703-0036
ICR 201610-0703-003 · OMB 0703-0036 · Object 69117201.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.presentationml.presentation |
|---|---|
| File Title | OMB 0703-0036 |
| Author | Windows User |
| Last Modified By | Impress |
| File Modified | 2016-10-24 |
| File Created | 2026-08-01 |
| Conversion State | failed_conversion |
Extracted Text
OMB: 0703-0036 EXP: XX XXXX Screen Shots with Intended Changes Privacy Act Statement FOR OFFICIAL USE ONLY – PRIVACY ACT SENSITIVE: Any misuse or unauthorized disclosure of this information may result in both criminal and civil penalties. PRIVACY ACT STATEMENT: Authority: 10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 6954, Midshipmen: number; 10 U.S.C. 6956, Midshipmen: Nominations and Selection to fill Vacancies; 10 U.S.C. 6957, Selection of Persons form Foreign Countries; 10 U.S.C. 6958, Midshipmen: Qualifications for Admissions; 10 U.S.C. 6962, Midshipmen: Discharge for Unsatisfactory Conduct or Inaptitude; 10 U.S.C. 6958, Midshipmen: Discharge for Deficiency; E.O. 9397 (SSN), as amended; DoDI 1322.22, Service Academies; and N01531-1. Purpose: Applicant files contain information used for personal information verification and to evaluate/determine competitive standing and eligibility for appointment to the Naval Academy. Midshipmen records consist of academic, military, and physical records used to track each students progress in the Naval Academy program. Routine Use: Information will only be collected and accessed by the United States Naval Academy for the purpose of admissions and enrollment. Additionally, records may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 522a(b)(3) as follows: 1.) to Congressional staffers for the purpose of reviewing applicants for status, nomination, and admission to the Naval Academy; 2.) to parents and legal guardians of midshipmen for academic, performance, disciplinary, health, and/or welfare issues; 3.) to the United States Naval Academy Sponsor Program for the purpose of assigning Midshipmen with a sponsor; 4.) to the United States Naval Institute for the purpose of relaying information about benefits; 5.) to the Naval Academy Athletic Association for the purpose of promoting and funding the Naval Academy Intercollegiate Athletic Program; 6.) to the United States Naval Academy Foundation for the purpose of sponsoring midshipmen candidates; and 7.) to the United States Naval Academy Alumni Association for the purpose of supporting the Naval Academy mission. Disclosure: Voluntary; however, failure to provide the required information may result in a delay or inability to process the applicant’s application or allow for the continued enrollment of a Midshipman at the Naval Academy. Privacy Act Statement OMB Symbol OMB Symbol Agency Disclosure Notice AGENCY DISCLOSURE NOTICE: The public reporting burden for this collection of information is estimated to average 1.35 hours, 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 (0703-0036). Respondents should be aware that notwithstanding any other provision 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 current valid OMB control number. PLEASE DO NOT RETURN YOUR RESPONSE TO THE ABOVE ADDRESS. Responses should be sent to: United States Naval Academy, Office of Admissions, 52 King George St., Annapolis, MD. 21402 Agency Disclosure Notice 1531/34 USNA Preliminary Application OMB Symbol Privacy Act Statement 1531/34 USNA Preliminary Application 1531/34 USNA Preliminary Application 1531/34 USNA Preliminary Application Agency Disclosure Notice Candidate Log In Page OMB Symbol Privacy Act Statement Agency Disclosure Notice Candidate Information System Page OMB Symbol Privacy Act Statement Candidate Information System Page Agency Disclosure Notice Candidate Information System Candidate Update Module OMB Symbol Privacy Act Statement Agency Disclosure Notice Personal Data Record Personal Information Personal Data Record Schools Attended Personal Data Record Prior Service 1110/12 Personal Data Record Police Record/School Probations 1110/12 Personal Data Record Police Record/School Probations 1110/12 Personal Data Record Father/Stepfather Information 1110/12 Personal Data Record Father/Stepfather Information 1110/12 Personal Data Record Mother/Stepmother Information 1110/12 Personal Data Record Mother/Stepmother Information 1110/12 Personal Data Record Sibling Information 1110/12 Personal Data Record Current Studies 1110/12 Personal Data Record Current Studies 1110/12 Personal Data Record Academic Interest 1110/12 Personal Data Record Language Skills 1110/12 Personal Data Record Additional Information 1110/12 Personal Data Record Additional Information 1110/12 Personal Data Record Personal Statement 1110/12 Personal Data Record Summary/Submission 1110/12 Personal Data Record Summary/Submission 1110/12 Personal Data Record Summary/Submission 1110/12 Personal Data Record Summary/Submission 1110/12 Personal Data Record Summary/Submission 1110/91 Candidate Fitness Assessment 1110/91 Candidate Fitness Assessment 1110/91 Candidate Fitness Assessment Privacy Act Statement Agency Disclosure Notice OMB Symbol 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record 1110/11 Candidate Activities Record Verification Email 1110/11 Candidate Activities Record Verification OMB Symbol Privacy Act Statement 1110/11 Candidate Activities Record Verification Agency Disclosure Notice English Recommendation English Recommendation English Recommendation OMB Symbol Privacy Act Statement English Recommendation Agency Disclosure Notice Math Recommendation Math Recommendation Math Recommendation OMB Symbol Privacy Act Statement Math Recommendation Agency Disclosure Notice 1110/15 Candidate Academic Information/Request for Transcript 1110/15 Candidate Academic Information/Request for Transcript 1110/15 Candidate Academic Information/Request for Transcript OMB Symbol Privacy Act Statement 1110/15 Candidate Academic Information/Request for Transcript Agency Disclosure Notice 1110/92 Request for Information Application OMB Symbol Privacy Act Statement 1110/92 Request for Information Application Agency Disclosure Notice Summer Seminar OMB Symbol Privacy Act Statement Summer Seminar Summer Seminar Summer Seminar Summer Seminar Summer Seminar Summer Seminar Agency Disclosure Notice