Request for Reference

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 370 Request for Reference	Form	Modified	Available
Form DD Form 370 Request for Reference	Form	Modified	Available
0704-0167_MIRS PIA.pdf	Supplementary Document	Uploaded 2023-07-24	Available
0704-0167_SSA_8.25.2023.docx	Supporting Statement A	Uploaded 2023-08-25	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5270	Request for Reference	Form	Modified	Request for Reference
5270	Request for Reference	Form	Modified

ICR Details

OMB Control No: 0704-0167	ICR Reference No: 202306-0704-002
Status: Active	Previous ICR Reference No: 202007-0704-006
Agency/Subagency: DOW/DODDEP	Agency Tracking No:
Title: Request for Reference
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/27/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/25/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2026	36 Months From Approved	09/30/2023
Responses	50,000	0	50,000
Time Burden (Hours)	8,333	0	8,500
Cost Burden (Dollars)	60,417	0	61,500

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Abstract: Title 10 USC, Sections 504, 505, 508, and 12102 establish minimum standards for enlistment in the Armed Forces. This information collection is for reference information on individuals applying for enlistment in the Armed Forces of the United States who require a waiver. The form associated with this information collection, DD Form 370, "Request for Reference", is used by recruiters to obtain reference information on applicants who have admitted to committing a civil or criminal offense. The respondents may provide character information that would allow the appicant to be considered.

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Authorizing Statute(s): US Code: 10 USC 505
   US Code: 10 USC 508
   US Code: 10 USC 12102
   US Code: 10 USC 504
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 33586	05/24/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 58256	08/25/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Request for Reference	DD Form 370	Request for Reference

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	50,000	50,000	0	0	0	0
Annual Time Burden (Hours)	8,333	8,500	0	-167	0	0
Annual Cost Burden (Dollars)	60,417	61,500	0	-1,083	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden has not actually changed. The system is showing a change due to a corrected mathematical error.

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Annual Cost to Federal Government: $317,500

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/25/2023

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