Information Collection

DD Form 0565

IC 263044 under ICR 202310-0704-002 · OMB 0704-0581.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 565 DD Form 0565	Form and Instruction
Form DD Form 565 STATEMENT OF RECOGNITION OF DECEASED DD Form 0565	Form and Instruction
DD Form 565 STATEMENT OF RECOGNITION OF DECEASED DD565 Draft 20240626.pdf	Form and Instruction
DD Form 565 STATEMENT OF RECOGNITION OF DECEASED DD565 Draft 20240626.pdf	Form and Instruction

IC Title:

DD Form 0565

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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 565				Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	453	453

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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