USMC Children, Youth and Teen Programs (CYTP) Registration Packet

Forms and Documents

Document Name	Status
Form NAVMC 1750/5 USMC Children, Youth and Teen Programs (CYTP) Registration Packet Form	New
DRAFT SORN NM01754-3 (WM added).docx Supplementary Document	2017-09-18
0703-AADP SS-A.DOCX Supporting Statement A	2017-09-18

IC Document Collections

IC ID	Document Title	Status
228240	USMC Children, Youth and Teen Programs (CYTP) Registration Packet Form	New

ICR Details

OMB Control No: 0703-0068	ICR Reference No: 201709-0703-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/NAVY	Agency Tracking No: 0703-AADP
Title: USMC Children, Youth and Teen Programs (CYTP) Registration Packet
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/20/2017
	Date Received in OIRA: 09/19/2017
Terms of Clearance: DOD must report this collection in the Information Collection Budget. In addition, DOD should re-write the Privacy Act notices to be more user-friendly before this collection is resubmitted for OMB review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved
Responses	112,000	0	0
Time Burden (Hours)	131,040	0	0
Cost Burden (Dollars)	2,320,640	0	0

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Abstract: The information collected on these forms is used by MFP and Inclusion Action Team (IAT) professionals for purposes of patron registration, to determine the general health status of patrons participating in CYTP activities and if necessary the appropriate accommodations for the patron for full enjoyment of CYTP services, and provides consent for information to be exchanged between MFP personnel and other designated individuals or organizations about a patron participating in MFP.

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Authorizing Statute(s): US Code: 10 USC 5013 Name of Law: Secretary of the Navy
   US Code: 10 USC 5041 Name of Law: Headquarters, Marine Corps
   US Code: 10 USC 88, Subch. II Name of Law: Military Family Programs and Military Child Care: Military Child Care
   EO: EO 9397 Name/Subject of EO: SSN
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 20867	05/03/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 42337	09/07/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
USMC Children, Youth and Teen Programs (CYTP) Registration Packet	NAVMC 1750/4, NAVMC 11720, NAVMC 1750/5	USMC Children, Youth & Teen Programs Registration Form ,   USMC FAMILY CARE PROGRAMS CONSENT TO RELEASE INFORMATION ,   USMC Children, Youth & Teen Programs (CYTP) Health Assessment

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	112,000	0	0	112,000	0	0
Annual Time Burden (Hours)	131,040	0	0	131,040	0	0
Annual Cost Burden (Dollars)	2,320,640	0	0	2,320,640	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $1,182,820

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/19/2017

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