Camp Lejeune Drinking Water Notification Registry

Camp Lejeune Notification Database

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Camp Lejeune Drinking Water Notification Registry	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.