Information Collection

Application for Department of Defense Common Access Card - DEERS Enrollment

IC 5503 under ICR 202604-0704-001 · OMB 0704-0415.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 1172-2 Application for Identification Cards/DEERS Enrollment Application for Department of Defense Common Access Card - DEERS Enrollment	Form
DD Form 1172-2 Application for Identification Cards/DEERS Enrollment dd1172-2.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	DD Form 1172-2				Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: DMDC 02 - Defense Enrollment Eligibility Reporting Systems (DEERS)

FR Citation: 77 FR 69807

Number of Respondents: 2,153,182

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 42 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,153,182	-135,695	2,288,877
Annual IC Time Burden (Hours)	107,659	-6,785	114,444
Annual IC Cost Burden (Dollars)	3,270,683	66,255	3,204,428

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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