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Federal forms, ICRs, and supporting documents

Information Collection

Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States

IC 5258 under ICR 202308-0704-002 · OMB 0704-0100.

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Information Collection (IC) Details

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Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form DD Form 2168 Application for Discharge of Member or Survivor of Member of Group Certified to have Performed Active Duty with the Armed Forces of the Untied States dd2168 unlocked - for OMB edits.PDF Yes No Fillable Printable

Defense and National Security Operational Defense

 

500 0
   
Individuals or Households
 
   20 %

  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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 250 0 0 0 0 250
Annual IC Cost Burden (Dollars) 1,815 0 0 0 0 1,815

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.