Dependency Statement - Parent

Dependency Statements: Parent, Incapacitated Child Over Age 21, Full Time Student 21-22, Ward of a Court

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0730-0014 can be found here:

Documents and Forms

Document Name Document Type
Form DD-137-3 Dependency Statement - Parent Form and Instruction
DD-137-3 Dependency Statement - Parent dd0137-3 draft 2.1.2021.pdf Form and Instruction
DD-137-3 Dependency Statement - Parent dd0137-3 draft 2.1.2021.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Dependency Statement - Parent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD-137-3	Dependency Statement - Parent	dd0137-3 draft 2.1.2021.pdf		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: 6,925	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,925	6,925
Annual IC Time Burden (Hours)	6,925	6,925
Annual IC Cost Burden (Dollars)	153,320	153,320

Documents for IC

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.