Application for Former Spouse Payments from Retired Pay

Forms and Documents

Document Name	Status
Form DD Form 2293 Application for Former Spouse Payments from Retired Pay Form and Instruction	Unchanged
T7347b DRAS.docx Supplementary Document	2020-03-20
0730-0008_SSA_4.24.2020.docx Supporting Statement A	2020-04-24

IC Document Collections

IC ID	Document Title	Status
5635	Application for Former Spouse Payments from Retired Pay Form and Instruction	Unchanged

ICR Details

OMB Control No: 0730-0008	ICR Reference No: 202003-0730-002
Status: Active	Previous ICR Reference No: 201702-0730-002
Agency/Subagency: DOD/DFAS	Agency Tracking No:
Title: Application for Former Spouse Payments from Retired Pay
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/24/2020
	Date Received in OIRA: 03/20/2020
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	04/30/2020
Responses	25,000	0	25,000
Time Burden (Hours)	12,500	0	12,500
Cost Burden (Dollars)	90,625	0	90,625

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Abstract: This form provides a uniform method for applicants to provide statutorily required information when seeking payments under the Uniform Services Former Spouse's Protection Act (10 U.S.C. 1408). The former spouse must request direct payment on court ordered child support, alimony, or division of property to a former spouse from the retired pay of a Uniformed Service Member.

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Authorizing Statute(s): US Code: 10 USC 1408 Name of Law: Payment of Retired or Retainer Pay in Compliance with Court Orders
  

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:
	85 FR 3040	01/17/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 16087	03/20/2020
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Application for Former Spouse Payments from Retired Pay	DD Form 2293	Application for Former Spouse Payments From Retired Pay

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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	25,000	25,000	0	0	0	0
Annual Time Burden (Hours)	12,500	12,500	0	0	0	0
Annual Cost Burden (Dollars)	90,625	90,625	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: $330,850

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: 03/20/2020

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