Information Collection

Camp Lejeune Drinking Water Notification Registry

IC 185160 under ICR 202301-0703-007 · OMB 0703-0057.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0703-0057_Collection Instrument.pdf www.marines.mil/clwater	Other-Website Screenshots
0703-0057_Collection Instrument.pdf www.marines.mil/clwater	Other-Website Screenshots

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Website Screenshots			0703-0057_Collection Instrument.pdf	http://www.marines.mil/clwater	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: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	10,000	0	10,000
Annual IC Time Burden (Hours)	1,000	0	1,000
Annual IC Cost Burden (Dollars)	28,010	4,780	23,230

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.