Information Collection

Personnel Accountability and Assessment for a Public Health Emergency

IC 241131 under ICR 202308-0720-002 · OMB 0720-0067.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 3112 Personnel Accountability and Assessment for a Public Health Emergency	Form and Instruction
Form DD Form 3112 Personnel Accountability and Assessment Notification for a Public Health Emergency Personnel Accountability and Assessment for a Public Health Emergency	Form and Instruction
DD Form 3112 Personnel Accountability and Assessment Notification for dd3112.pdf	Form and Instruction
DD Form 3112 Personnel Accountability and Assessment Notification for dd3112.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	DD Form 3112				Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: Defense Accountability and Assessment Records

FR Citation: 88 FR 60192

Number of Respondents: 100,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	8,333	8,333
Annual IC Cost Burden (Dollars)	60,000	60,000

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.

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