Information Collection

Personal Information Questionnaire

IC 277758 under ICR 202509-0712-006 · OMB 0712-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NAVMC 10064 Personal Information Questionnaire Personal Information Questionnaire	Form
NAVMC 10064 Personal Information Questionnaire 0712-0002_NAVMC 10064 (02-23).pdf	Form

IC Title:

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	NAVMC 10064				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: 3,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	875	875
Annual IC Cost Burden (Dollars)	21,105	21,105

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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