Information Collection

United States Naval Academy Candidate Application Forms

IC 5226 under ICR 201610-0703-003 · OMB 0703-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument Mock-Up_Screenshots 0703-0036.pptx	Other-Instrument Mock-Up Screenshots
USNA 1110 Candidate Interview Protocol USNA 1110 Candidate Interview Protocol.docx	Form
USNA 5500 Police Record Check USNA 5500_1 Police Record Check.pdf	Form

IC Title:

United States Naval Academy Candidate Application Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 10 CFR 6958

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instrument Mock-Up Screenshots			Instrument Mock-Up_Screenshots 0703-0036.pptx	Yes	Yes	Fillable Fileable Signable
Form	USNA 1110	Candidate Interview Protocol	USNA 1110 Candidate Interview Protocol.docx	Yes	Yes	Fillable Fileable
Form	USNA 5500	Police Record Check	USNA 5500_1 Police Record Check.pdf	No		Printable Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 84,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 83 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	84,000	70,000	14,000
Annual IC Time Burden (Hours)	99,165	43,165	56,000
Annual IC Cost Burden (Dollars)	1,618,540	218,540	1,400,000

Documents for IC

table that charts IC Documents
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.