Information Collection

Marine Corps NAF Group Insurance and Retirement Enrollment Waiver Change Agreement Form

IC 253050 under ICR 202204-0703-003 · OMB 0703-0071.

Documents and Forms

Document Name Document Type
Form NAVMC 12000/499 Marine Corps NAF Group Insurance and Retirement Enrollment Waiver Change Agreement Form Form
NAVMC 12000/499 Marine Corps NAF Group Insurance and Retirement Agreemen NAVMC_XXXX_Review_MC_NAF_Group_Insur_Retir_Agreement(10b).pdf Form
NAVMC 12000/499 Marine Corps NAF Group Insurance and Retirement Agreemen NAVMC_XXXX_Review_MC_NAF_Group_Insur_Retir_Agreement(10b).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Marine Corps NAF Group Insurance and Retirement Enrollment Waiver Change Agreement Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NAVMC 12000/499	Marine Corps NAF Group Insurance and Retirement Agreement	NAVMC_XXXX_Review_MC_NAF_Group_Insur_Retir_Agreement(10b).pdf		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: 50	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	50	50
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	253	253

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.