Physician Certificate for Child Annuitant

Physician Certificate for Child Annuitant

OMB: 0730-0011

IC ID: 5643

Information Collection (IC) Details

View Information Collection (IC)

Physician Certificate for Child Annuitant
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Request form Request form.doc No   Paper Only
Form DD 2828 Physician Certificate for Child Annuitant DD2828 20170403 old address.PDF http://www.dtic.mil/whs/directives/forms/index.htm Yes No Fillable Printable

Defense and National Security Operational Defense

Defense Military Retiree and Annuity Pay System Records  74 FR 696

240 0
   
Individuals or Households
 
   15 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 240 0 120 0 120 0
Annual IC Time Burden (Hours) 240 0 0 0 240 0
Annual IC Cost Burden (Dollars) 11,670 0 11,670 0 0 0

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

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