Forms Relating to Military Service Records

Forms Relating to Military Service Records

OMB: 3095-0039

IC ID: 32546

Information Collection (IC) Details

View Information Collection (IC)

Forms Relating to Military Service Records
 
No Modified
 
Required to Obtain or Retain Benefits
 
36 CFR 1233.18

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Form 13036 Authorization for Release of Military Medical Patient Records NA Form 13036, Authorization for Release of Military Medical Patient RecordsFINAL.docx http://www.archives.gov/st-louis/military-personnel/public/medical-records-veterans-access.html Yes No Fillable Printable
Form and Instruction NA Form 13042 Request for Information Needed to Locate Medical Records NA Form 13042, Request for Information Needed to Locate Medical RecordsFINAL.docx http://www.archives.gov/st-louis/military-personnel/na-13042-request-4-information-needed-2-locate-medical-records.pdf Yes No Fillable Printable
Form and Instruction NA Form 13055 Request for Information Needed to Reconstruct Medical Data NA Form 13055, Request for Information Needed to Reconstruct Medical DataFINAL.docx http://www.archives.gov/st-louis/military-personnel/na-13055-info-2-reconstruct-medical-data.pdf Yes Yes Fillable Printable
Form and Instruction NA Form 13075 Questionnaire about Military Service NA Form 13075, Questionnaire About Military ServiceFINAL.docx http://www.archives.gov/st-louis/military-personnel/na-13075-questionnaire-about-military-service.pdf Yes Yes Fillable Printable
Form and Instruction NA Form 13177 Check the Status of a Clinical & Medical Treatment Records Request NA13177_06_2017_3095-0039.pdf https://www.archives.gov/forms/st-louis/clinical-followup.html Yes Yes Fillable Fileable

Education Cultural and Historic Preservation

NARA 35 Case Management and Reporting System (CMRS)  78 FR 77256

132,500 0
   
Individuals or Households
 
   0 %

  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 132,500 0 52,700 0 0 79,800
Annual IC Time Burden (Hours) 11,042 0 4,392 0 0 6,650
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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