Application for the Review of Discharge from the Armed Forces of the United States

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 293 Application for the Review of Discharge from the Armed Forces of the US.	Form	Modified	Available
Form DD Form 293 Application for the Review of Discharge from the Armed Forces of the United States	Form	Modified	Repair queued
0704-0004_PIA_Sec 1.pdf	Supplementary Document	Uploaded 2022-08-10	Repair queued
0704-0004_SSNMemo.pdf	Supplementary Document	Uploaded 2022-12-27	Repair queued
0704-0004_SSA_12.28.2022.docx	Supporting Statement A	Uploaded 2022-12-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5237	Application for the Review of Discharge from the Armed Forces of the United States	Form	Modified	Application for the Review of Discharge from the Armed Forces of the US.
5237	Application for the Review of Discharge from the Armed Forces of the United States	Form	Modified

ICR Details

OMB Control No: 0704-0004	ICR Reference No: 202207-0704-004
Status: Historical Active	Previous ICR Reference No: 201909-0704-008
Agency/Subagency: DOW/DODDEP	Agency Tracking No:
Title: Application for the Review of Discharge from the Armed Forces of the United States
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: 02/08/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/28/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	36 Months From Approved	02/28/2023
Responses	2,827	0	10,000
Time Burden (Hours)	1,414	0	7,500
Cost Burden (Dollars)	10,262	0	54,375

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Abstract: Under Title 10 USC 1553 and DOD Directive 1332.41, "Boards for the Correction of Military Records (BCMRs) and Discharge Review Board (DRBs)," former service members who received an administrative discharge have the right to appeal the characterization or reason for separation provided they do so within 15 years from the date of separation. The DD Form 293, "Application for Review of Discharge or Separation from the Armed Forces of the United States," is the form that allows former Service members to explain the reasons for the alleged error, designate legal counsel, and provides DRBs necessary information to process requests.

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Authorizing Statute(s): US Code: 10 USC 1553
  

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 48164	08/08/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 79292	12/27/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for the Review of Discharge from the Armed Forces of the United States	DD Form 293	Application for the Review of Discharge from the Armed Forces of the US.

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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	2,827	10,000	0	-7,173	0	0
Annual Time Burden (Hours)	1,414	7,500	0	-6,086	0	0
Annual Cost Burden (Dollars)	10,262	54,375	0	-44,113	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden has decreased due to a decrease in the number of respondents.

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Annual Cost to Federal Government: $3,733,254

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: 12/28/2022

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