Navy Flight Demonstration Squadron (Blue Angels) Backseat Rider Programs Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form OPNAV 5720/15 F/A-18 Medical Questionnaire	Form	Modified	Available
Form OPNAV 5720/15 OPNAV Form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft	Form	Modified	Repair queued
Form OPNAV 5720/13 Media Rider Nominee	Form and Instruction	Modified	Available
Form OPNAV 5720/13 OPNAV 5720/13, "Media Rider Nominee Form"	Form and Instruction	Modified	Repair queued
Form OPNAV 5720/14 Key Influencer Nominee Form and Biography	Form and Instruction	Modified	Available
Form OPNAV 5720/14 OPNAV Form 5720/14, "Key Influencer Nominee Form and Biography"	Form and Instruction	Modified	Repair queued
Narrative Statement N05726-1 13Sep18.docx	Supplementary Document	Uploaded 2022-05-16	Repair queued
Guest Flight Letter and Medical Directions - 2022 Support Manual.pdf	Supplementary Document	Uploaded 2022-05-16	Repair queued
0703-0073_SSA_5.17.2022.docx	Supporting Statement A	Uploaded 2022-05-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
235851	OPNAV Form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft	Form	Modified	F/A-18 Medical Questionnaire
235851	OPNAV Form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft	Form	Modified
235850	OPNAV 5720/13, "Media Rider Nominee Form"	Form and Instruction	Modified	Media Rider Nominee
235850	OPNAV 5720/13, "Media Rider Nominee Form"	Form and Instruction	Modified
235849	OPNAV Form 5720/14, "Key Influencer Nominee Form and Biography"	Form and Instruction	Modified	Key Influencer Nominee Form and Biography
235849	OPNAV Form 5720/14, "Key Influencer Nominee Form and Biography"	Form and Instruction	Modified

ICR Details

OMB Control No: 0703-0073	ICR Reference No: 202205-0703-001
Status: Historical Active	Previous ICR Reference No: 201904-0703-001
Agency/Subagency: DOW/NAVY	Agency Tracking No: 0703-AAVF
Title: Navy Flight Demonstration Squadron (Blue Angels) Backseat Rider Programs Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/19/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/18/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2025	36 Months From Approved	07/31/2022
Responses	480	0	480
Time Burden (Hours)	240	0	240
Cost Burden (Dollars)	6,882	0	6,515

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Abstract: The information collected is used to screen, medically clear, and coordinate with individuals who are nominated for orientation flights with the Blue Angels in connection with air shows and aerial demonstrations. These orientation flights promote Naval Aviation professionalism and directly contribute to public understanding of the roles and missions of the Navy and Marine Corps.

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Authorizing Statute(s): US Code: 10 USC 5013 Name of Law: Secretary of the Navy
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 14524	03/15/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 29303	05/13/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
OPNAV 5720/13, "Media Rider Nominee Form"	OPNAV 5720/13	Media Rider Nominee
OPNAV Form 5720/14, "Key Influencer Nominee Form and Biography"	OPNAV 5720/14	Key Influencer Nominee Form and Biography
OPNAV Form 5720/15, "Medical Questionnaire for Non-Military Personnel to Fly in U.S. Navy Blue Angels Aircraft	OPNAV 5720/15	F/A-18 Medical Questionnaire

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	480	480	0	0	0	0
Annual Time Burden (Hours)	240	240	0	0	0	0
Annual Cost Burden (Dollars)	6,882	6,515	0	367	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $8,856

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/18/2022

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