Forms Relating to Civilian Service Records

ICR 201902-3095-001

OMB: 3095-0037

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2019-02-14
IC Document Collections
ICR Details
3095-0037 201902-3095-001
Active 201512-3095-003
NARA
Forms Relating to Civilian Service Records
Extension without change of a currently approved collection   No
Regular
Approved without change 04/15/2019
Retrieve Notice of Action (NOA) 02/14/2019
  Inventory as of this Action Requested Previously Approved
04/30/2022 36 Months From Approved 04/30/2019
20,800 0 20,800
1,733 0 1,733
0 0 0

Former Federal civilian employees and other authorized individuals use this information collection in order to obtain information from Official Personnel Folders or Employee Medical Folders.

None
None

Not associated with rulemaking

  83 FR 54945 11/01/2018
84 FR 3502 02/12/2019
No

1
IC Title Form No. Form Name
Forms Relating to Civilian Service Records NA Form 13064, NA Form 13068, NA Form 13022 Walk-In Request for OPM Records or Information ,   Returnred Request ,   Reply to Request Involving Relief Agencies

  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 20,800 20,800 0 0 0 0
Annual Time Burden (Hours) 1,733 1,733 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    No
No
No
No
Uncollected
Tamee Fechhelm 301-837-3204 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/14/2019


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