Information Collection

Dfars 252.236-7004

IC 246389 under ICR 202103-0704-006 · OMB 0704-0255.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0255 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Collection Instrument 0704-0255.docx	Other-Clauses
Collection Instrument 0704-0255.docx	Other-Clauses

IC Title:

DFARS 252.236-7004

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 48 CFR 252

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
Other-Clauses			Collection Instrument 0704-0255.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	86	86
Annual IC Time Burden (Hours)	1,720	1,720
Annual IC Cost Burden (Dollars)	82,560	82,560

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.