Information Collection

DoD Consent to Conduct Installation Records Check

IC 236654 under ICR 201906-0704-003 · OMB 0704-0586.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0586 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 3058 Department of Defense Consent to Conduct Installation Records Check DoD Consent to Conduct Installation Records Check	Form
DD Form 3058 Department of Defense Consent to Conduct Installation Re dd3058 draft 20190513.pdf	Form

IC Title:

DoD Consent to Conduct Installation Records Check

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 3058				Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	14,000	14,000
Annual IC Time Burden (Hours)	2,333	2,333
Annual IC Cost Burden (Dollars)	16,800	16,800

Documents for IC

table that charts IC Documents
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.

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