Information Collection

Camp Lejeune Drinking Water Notification Registry

IC 185160 under ICR 201912-0703-003 · OMB 0703-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Website screenshot with dropdown.pdf www.marines.mil/clwater	Other-Website Screenshots
PAS and ADN screenshot.PDF	Other-Screenshot
0703-0057 _Registration Letter~plementary Document_11.19.2019.PDF	Other-Registration Letter

IC Title:

Camp Lejeune Drinking Water Notification Registry

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Website Screenshots	Website screenshot with dropdown.pdf	http://www.marines.mil/clwater	Yes	Yes	Fillable Fileable
Other-Screenshot	PAS and ADN screenshot.PDF		No		Fillable Fileable
Other-Registration Letter	0703-0057 _Registration Letter~plementary Document_11.19.2019.PDF		No		Printable Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	23,230	23,230

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.