Information Collection

Secondary Dependency Application Form

IC 247450 under ICR 202406-0730-001 · OMB 0730-0014.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 137 Secondary Dependency Application Form	Form and Instruction
DD Form 137 Secondary Dependency Application DD137 DRAFT 20240627.pdf	Form and Instruction
DD Form 137 Secondary Dependency Application DD137 DRAFT 20240627.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 137	Secondary Dependency Application	DD137 DRAFT 20240627.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: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20,000	16,529	3,471
Annual IC Time Burden (Hours)	10,000	7,397	2,603
Annual IC Cost Burden (Dollars)	332,200	274,547	57,653

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.