Information Collection

Application for Former Spouse Payments from Retired Pay

IC 5635 under ICR 201702-0730-002 · OMB 0730-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0730-0008 can be found here:

Documents and Forms

Document Name Document Type
Form DD Form 2293 Application for Former Spouse Payments from Retired Pay Form and Instruction
M-4.doc Other-Letter to Member
M-33.doc Other-Letter to Claimant
M-34.doc Other-Rejection Letter to Requester
REJECT PARAGRAPHS.doc Other-Rejection Paragraphs for Rejec
DD Form 2293 Application for Former Spouse Payments From Retired Pay DD Form 2293 20170118.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Former Spouse Payments from Retired Pay	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD Form 2293	Application for Former Spouse Payments From Retired Pay	DD Form 2293 20170118.pdf	Yes	No	Fillable Printable
Other-Letter to Member			M-4.doc	No		Paper Only
Other-Letter to Claimant			M-33.doc	No		Paper Only
Other-Rejection Letter to Requester			M-34.doc	No		Paper Only
Other-Rejection Paragraphs for Rejection Letter			REJECT PARAGRAPHS.doc	No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title: Defense Military Retiree and Annuity Pay System	FR Citation: 74 FR 696

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	25,000	-4,127	29,127
Annual IC Time Burden (Hours)	12,500	5,218	7,282
Annual IC Cost Burden (Dollars)	90,625	-73,651	164,276

Documents for IC

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.