Information Collection

Marine Corps NAF Group Insurance and Retirement Agreement Form

IC 253050 under ICR 202508-0712-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 12000_499 MARINE CORPS NAF GROUP INSURANCE AND RETIREMENT AGREEMENT Marine Corps NAF Group Insurance and Retirement Agreement Form	Form and Instruction
Form 12000_49C CONTINUATION FOR MARINE CORPS NAF GROUP INSURANCE AND RETIREMENT AGREEMENT Marine Corps NAF Group Insurance and Retirement Agreement Form	Form and Instruction
12000_499 MARINE CORPS NAF GROUP INSURANCE AND RETIREMENT AGREEMEN NAVMC 12000_499 approved.pdf	Form and Instruction
12000_49C CONTINUATION FOR MARINE CORPS NAF GROUP INSURANCE AND RE NAVMC 12000_499C approved.pdf	Form and Instruction

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 and Instruction	12000_499				Yes	Yes	Fillable Fileable Signable
Form and Instruction	12000_49C				Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50	0	50
Annual IC Time Burden (Hours)	13	0	13
Annual IC Cost Burden (Dollars)	289	36	253

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.

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