Information Collection

Personal Information Questionnaire

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Personal Information Questionnaire	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
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 %

	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

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.