Information Collection

Restricted Sexual Assault Report

IC 231892 under ICR 202107-0703-003 · OMB 0703-0069.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0069 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DRAFT FORM RESTRICTED SEXUAL ASSAULT REPORT	Form and Instruction
DRAFT FORM RESTRICTED SEXUAL ASSUALT REPORT 0703-0069_ RSAR (catch) DD3055 DRAFT Form_ 20210811.pdf profile.ncis.navy.mil/	Form and Instruction
DRAFT FORM RESTRICTED SEXUAL ASSUALT REPORT 0703-0069_ RSAR (catch) DD3055 DRAFT Form_ 20210811.pdf profile.ncis.navy.mil/	Form and Instruction

IC Title:

RESTRICTED SEXUAL ASSAULT REPORT

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DRAFT FORM	RESTRICTED SEXUAL ASSUALT REPORT	0703-0069_ RSAR (catch) DD3055 DRAFT Form_ 20210811.pdf	https://profile.ncis.navy.mil/	Yes	Yes	Fillable Printable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	25	-275	300
Annual IC Time Burden (Hours)	13	-137	150
Annual IC Cost Burden (Dollars)	298	-3,281	3,579

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.