Information Collection

DD Form 0565

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

Documents and Forms

Document Name Document Type
Form DD Form 565 DD Form 0565 Form and Instruction
DD Form 565 STATEMENT OF RECOGNITION OF DECEASED DD565 Draft 20240626.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD Form 565	STATEMENT OF RECOGNITION OF DECEASED	DD565 Draft 20240626.pdf		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 %

	Requested	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

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.