Information Collection

Personal Information Questionnaire

IC 5207 under ICR 202302-0712-003 · OMB 0712-0003.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NAVMC Form 10064 Personal Information Questionnaire	Form and Instruction
NAVMC Form 10064 Personal Information Questionnaire NAVMC 10064_6.15.2022.pdf	Form and Instruction

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
Form and Instruction	NAVMC Form 10064	Personal Information Questionnaire	NAVMC 10064_6.15.2022.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,500	0	3,500
Annual IC Time Burden (Hours)	875	0	875
Annual IC Cost Burden (Dollars)	18,270	4,060	14,210

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.