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Federal forms, ICRs, and supporting documents

Information Collection

Reserve Component Survivor Benefit Program Election Certificate

IC 241185 under ICR 202304-0704-002 · OMB 0704-0569.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form DD 2656-5
Reserve Component Survivor Benefit Program Election Certificate		 Form and Instruction
DD 2656-5 Reserve Component Survivor Benefit Program Election Cert
dd2656-5.PDF 		Form and Instruction
DD 2656-5 Reserve Component Survivor Benefit Program Election Cert
dd2656-5.PDF 		Form and Instruction
0704-0569_ SSN Justification (DD 2656).pdf
SS Justification		IC Document
0704-0569_ SSN Justification (DD 2656).pdf
SS Justification		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 DD 2656-5 Reserve Component Survivor Benefit Program Election Certificate dd2656-5.PDF Yes Yes Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,900 0 0 0 0 5,900
Annual IC Time Burden (Hours) 1,475 0 0 0 0 1,475
Annual IC Cost Burden (Dollars) 38,881 0 0 0 0 38,881

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
SS Justification 0704-0569_ SSN Justification (DD 2656).pdf 04/07/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.