Information Collection

Uniformed Services Employment and Reemployment Rights Act (USERRA) Inquiry

IC 263806 under ICR 202403-0704-002 · OMB 0704-0678.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD3021 Uniformed Services Employment and Reemployment Rights Act (USERRA) Inquiry	Form
DD3021 Uniformed Services Employment and Reemployment Rights Ac DD3021 DRAFT 20221110.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	DD3021	Uniformed Services Employment and Reemployment Rights Act Inquiry	DD3021 DRAFT 20221110.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: 977

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	977	977
Annual IC Time Burden (Hours)	81	81
Annual IC Cost Burden (Dollars)	2,117	2,117

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.