Information Collection Request
PFPA Recruitment, Medical, and Fitness Forms
ICR 202209-0704-004 · OMB 0704-0588 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0704-0588 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form PFPA Form 1408 1. Application Status Request (PFPA Form 1408) |
Form and Instruction | Modified | Repair queued |
| Form PFPA Form 1409 Character Reference Questionnaire (PFPA Form 1409) |
Form and Instruction | Unchanged | Repair queued |
| Form PFPA Form 1410 Employer Reference Questionnaire (PFPA Form 1410) |
Form and Instruction | Unchanged | Repair queued |
| Form PFPA Form 1407 Internal Affairs Request (PFPA Form 1407) |
Form and Instruction | Unchanged | Repair queued |
| Form PFPA Form 6040 Supplemental Medical History Questionnaire (PFPA Form 6040) |
Form and Instruction | Unchanged | Repair queued |
| Form PFPA Form 1400 Authorization for Release of Information (PFPA Form 1400) |
Form and Instruction | Unchanged | Repair queued |
 Salesforce DRAFT PIA.pdf |
Supplementary Document | Uploaded 2022-11-29 | Repair queued |
 0704-0588 SSA 11.28.22.docx |
Supporting Statement A | Uploaded 2022-11-28 | Repair queued |
| FORM 1410_Email & Phone Script.docx |
Supplementary Document | Uploaded 2022-11-28 | Repair queued |
| FORM 1409_Email & Phone Script.docx |
Supplementary Document | Uploaded 2022-11-28 | Repair queued |
| FORM 1407_Email & Phone Script.docx |
Supplementary Document | Uploaded 2022-11-28 | Repair queued |
| 0704-0588 SSN Justification Memorandum.PDF |
Supplementary Document | Uploaded 2022-11-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 236337 |  1. Application Status Request (PFPA Form 1408) |
Form and Instruction | Modified | |
| 236336 | Character Reference Questionnaire (PFPA Form 1409) |
Form and Instruction | Unchanged | |
| 236262 | Employer Reference Questionnaire (PFPA Form 1410) |
Form and Instruction | Unchanged | |
| 236260 | Internal Affairs Request (PFPA Form 1407) |
Form and Instruction | Unchanged | |
| 236253 | Supplemental Medical History Questionnaire (PFPA Form 6040) |
Form and Instruction | Unchanged | |
| 236251 | Authorization for Release of Information (PFPA Form 1400) |
Form and Instruction | Unchanged |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOD/DODDEP |
| OMB Control No | 0704-0588 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201905-0704-007 |
| Agency Tracking No | 0704-AABZ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |