Exchange Official Personnel Folder - Privilege Card

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Exchange Form 1100 Identification and Privilege Card Application	Form	Modified	Available
Supporting Statement A-0702-0129 Final Update (Renewal 2018)(2).DOCX	Supporting Statement A	Uploaded 2018-12-19	Available
PIA - OPF.PDF	Supplementary Document	Uploaded 2018-12-17	Available
OPF SORN (2018-DRAFT).DOCX	Supplementary Document	Uploaded 2018-12-07	Available
SSN JUSTIFICATION (1100-016).PDF	Supplementary Document	Uploaded 2018-12-07	Available
DD FORM 2574(Portrait View).pdf	Supplementary Document	Uploaded 2018-12-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
219006	Identification and Privilege Card Application	Form	Modified

ICR Details

OMB Control No: 0702-0129	ICR Reference No: 201812-0702-001
Status: Active	Previous ICR Reference No: 201511-0702-001
Agency/Subagency: DOD/DOA	Agency Tracking No:
Title: Exchange Official Personnel Folder - Privilege Card
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/28/2019
	Date Received in OIRA: 12/19/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2022	36 Months From Approved	01/31/2019
Responses	2,500	0	2,500
Time Burden (Hours)	625	0	625
Cost Burden (Dollars)	4,525	0	4,525

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Abstract: Dependents and Exchange Retirees wishing to obtain or maintain status as an Exchange authorized patron for shopping privileges submit applications for an approved patronage card.

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Authorizing Statute(s): EO: EO 9397 Name/Subject of EO: SSN
   US Code: 10 USC 3013 Name of Law: Secretary of the Army
   US Code: 10 USC 8013 Name of Law: Secretary of the Air Force
  

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:
	83 FR 53611	10/24/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 65155	12/19/2018
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Identification and Privilege Card Application	Exchange Form 1100-016	Identification & Privilege Card Application

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ICR Summary of Burden

table that charts list 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	2,500	2,500	0	0	0	0
Annual Time Burden (Hours)	625	625	0	0	0	0
Annual Cost Burden (Dollars)	4,525	4,525	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $76,026

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: 12/19/2018

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