Navy Flight Demonstration Squadron (Blue Angels) Backseat Rider Programs, OPNAV Forms 5720/13, 5720/14, 572/15

Forms and Documents

Document Name	Status
Form OPNAV 5710/15 OPNAV form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft Form and Instruction	New
Form OPNAV 5720/13 OPNAV 5720/13 Media Rider Nominee Form Form and Instruction	New
Form OPNAV 5720/14 OPNAV Form 5720/14 Key Influencer Nominee Form and Biography Form and Instruction	New
Email to Respondents.pdf Supplementary Document	2019-04-29
SSA_0703-AAVF_4.29.19.docx Supporting Statement A	2019-04-29

IC Document Collections

IC ID	Document Title	Status
235851	OPNAV form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft Form and Instruction	New
235850	OPNAV 5720/13 Media Rider Nominee Form Form and Instruction	New
235849	OPNAV Form 5720/14 Key Influencer Nominee Form and Biography Form and Instruction	New

ICR Details

OMB Control No: 0703-0073	ICR Reference No: 201904-0703-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: DOD/NAVY	Agency Tracking No: 0703-AAVF
Title: Navy Flight Demonstration Squadron (Blue Angels) Backseat Rider Programs, OPNAV Forms 5720/13, 5720/14, 572/15
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/30/2019
	Date Received in OIRA: 04/29/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved
Responses	480	0	0
Time Burden (Hours)	240	0	0
Cost Burden (Dollars)	6,515	0	0

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Abstract: This information collected is used to screen, medically clear, and coordinate with individuals who are nominated for orientation flights with the Blue Angels in connection with air shows and aerial demonstrations. These orientation flights promote Naval Aviation professionalism and directly contribute to public understanding of the roles and missions of the Navy and Marine Corps.

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Authorizing Statute(s): US Code: 10 USC 5013 Name of Law: null
  

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 66255	12/26/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 18010	04/29/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
OPNAV Form 5720/14 Key Influencer Nominee Form and Biography	OPNAV 5720/14	Key Influencer Nominee Form and Biography
OPNAV 5720/13 Media Rider Nominee Form	OPNAV 5720/13	Media Rider Nominee Form
OPNAV form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft	OPNAV 5710/15	Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft

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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	480	0	0	480	0	0
Annual Time Burden (Hours)	240	0	0	240	0	0
Annual Cost Burden (Dollars)	6,515	0	0	6,515	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: $8,516

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: 04/29/2019

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