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Defense Sexual Assault Incident Supplementary Reporting
Defense Sexual Assault Incident Reporting
OMB: 0704-0482
IC ID: 234081
OMB.report
DOD/DODDEP
OMB 0704-0482
ICR 201811-0704-002
IC 234081
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0482 can be found here:
2022-01-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form DD Form 2910-2
Defense Sexual Assault Incident Supplementary Reporting
Form
DD Form 2910-2 Retaliation Reporting Statement for Unrestricted Sexual
dd2910-2 Draft 20181114.PDF
Form
DD Form 2910-1 Replacement of Lost DD Form 2910 Victim Reporting Prefer
dd2910-1 Draft 20181114.PDF
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Defense Sexual Assault Incident Supplementary Reporting
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
DD Form 2910-2
Retaliation Reporting Statement for Unrestricted Sexual Assault Cases
dd2910-2 Draft 20181114.PDF
Yes
Yes
Fillable Fileable
Form
DD Form 2910-1
Replacement of Lost DD Form 2910 Victim Reporting Preference Statement
dd2910-1 Draft 20181114.PDF
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
25 %
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
2
0
0
2
0
0
Annual IC Time Burden (Hours)
5
0
0
5
0
0
Annual IC Cost Burden (Dollars)
132
0
0
132
0
0
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.