Consent For Disclosure Of Records Protected Under The Privacy Act

Request for Individual Access to Records Protected Under the Privacy Act; Consent for Disclosure of Records Protected Under the Privacy Act

Documents and Forms

Document Name Document Type
Form DD Form 3214 CONSENT FOR DISCLOSURE OF RECORDS PROTECTED UNDER THE PRIVACY ACT Form and Instruction
DD Form 3214 CONSENT FOR DISCLOSURE OF RECORDS PROTECTED UNDER THE PR DD3214 DRAFT 20240905.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	CONSENT FOR DISCLOSURE OF 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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD Form 3214	CONSENT FOR DISCLOSURE OF RECORDS PROTECTED UNDER THE PRIVACY ACT	DD3214 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 %

	Requested	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

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.