Information Collection

DoD Active Duty/Reserve Forces Dental Examination

IC 43598 under ICR 202603-0720-001 · OMB 0720-0022.

Documents and Forms

Document Name Document Type
Form DD3128 DEPARTMENT OF DEFENSE ACTIVE DUTY/RESERVE/GUARD/CIVILIAN FORCES DENTAL EXAMINATION DoD Active Duty/Reserve Forces Dental Examination Form and Instruction
DD3128 DEPARTMENT OF DEFENSE ACTIVE DUTY/RESERVE/GUARD/CIVILIAN dd2813.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DoD Active Duty/Reserve Forces Dental Examination	Agency IC Tracking Number:	0720-0022

Is this a Common Form? No		IC Status: Modified

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	DD3128	DEPARTMENT OF DEFENSE ACTIVE DUTY/RESERVE/GUARD/CIVILIAN FORCES DENTAL EXAMINATION	dd2813.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: 150,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 70 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	750,000	0	750,000
Annual IC Time Burden (Hours)	37,500	0	37,500
Annual IC Cost Burden (Dollars)	3,742,500	3,120,000	622,500

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.

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