Information Collection

Application for Surrogate Association for DoD Self-Service (DS) Logon Form

IC 223842 under ICR 201610-0704-002 · OMB 0704-0559.

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Information Collection (IC) Details

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IC Title:	Application for Surrogate Association for DoD Self-Service (DS) Logon Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 32 CFR 221

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title: Defense Enrollment Eligibility Reporting Systems (DEERS)	FR Citation: 81 FR 49210

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	9,870	9,870

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.