Information Collection

Incident Report Form

IC 210253 under ICR 202210-0704-004 · OMB 0704-0514.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DLA 635 Incident Report Form	Form and Instruction
Defense Logistics Agency Log in Screen 4.19.2019.docx	Other-DLA Police Center Records Logi
Defense Logistics Agency Log in Screen 4.19.2019.docx	Other-DLA Police Center Records Logi
DLA_POLC_RMS_Application_Images.pdf	Other-Police Center Records System S
DLA_POLC_RMS_Application_Images.pdf	Other-Police Center Records System S
DLA 635 Incident Report DRAFT - DL0635.pdf	Form and Instruction
DLA 635 Incident Report DRAFT - DL0635.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DLA 635	Incident Report	DRAFT - DL0635.pdf	Yes	Yes	Fillable Fileable
Other-DLA Police Center Records Login Page			Defense Logistics Agency Log in Screen 4.19.2019.docx	Yes	Yes	Fillable Fileable
Other-Police Center Records System Screenshots			DLA_POLC_RMS_Application_Images.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: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	26,000	26,000

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.