Information Collection

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

IC 5649 under ICR 202101-0730-001 · OMB 0730-0014.

Information Collection (IC) Details

View Information Collection (IC)

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Information Collection Instruments:
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Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction DD Form 137-3 Dependency Statement-Parent dd0137-3 20170816.pdf Yes Yes Fillable Fileable Signable
Form and Instruction DD Form 137-5 Dependency Statement – Incapacitated Child Over Age 21 dd0137-5 20170718.pdf Yes Yes Fillable Fileable Signable
Form and Instruction DD Form 137-6 Dependency Statement – Full Time Student 21-22 Years of Age dd0137-6 20170718.pdf Yes Yes Fillable Fileable Signable
Form and Instruction DD Form 137-7 Dependency Statement – Ward of a Court dd0137-7 20170718.pdf Yes Yes Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module


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  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -14,975 0 0 14,975
Annual IC Time Burden (Hours) 0 0 -14,191 0 0 14,191
Annual IC Cost Burden (Dollars) 0 0 -305,527 0 0 305,527

Documents for IC
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Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.