Information Collection

Request For Individual Access To Records Protected Under The Privacy Act

IC 272863 under ICR 202412-0704-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Dorm 3213 REQUEST FOR INDIVIDUAL ACCESS TO RECORDS PROTECTED UNDER THE PRIVACY ACT	Form and Instruction
DD Dorm 3213 REQUEST FOR INDIVIDUAL ACCESS TO RECORDS PROTECTED UNDER DD3213 DRAFT 20240905.pdf	Form and Instruction
DD Dorm 3213 REQUEST FOR INDIVIDUAL ACCESS TO RECORDS PROTECTED UNDER DD3213 DRAFT 20240905.pdf	Form and Instruction

IC Title:

REQUEST FOR INDIVIDUAL ACCESS TO RECORDS PROTECTED UNDER THE PRIVACY ACT

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	DD Dorm 3213	REQUEST FOR INDIVIDUAL ACCESS TO RECORDS PROTECTED UNDER THE PRIVACY ACT	DD3213 DRAFT 20240905.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: Freedom of Information Act and Privacy Act Records (FOIA/PA Records) DoD-0008

FR Citation: 86 FR 72586

Number of Respondents: 15,000

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	11,250	11,250
Annual IC Cost Burden (Dollars)	343,125	343,125

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.