Data for Payment of Retired Personnel

Forms and Documents

Document Name	Status
Form DD Form 2656 Data For Payment of Retired Personnel Form and Instruction	Modified
0704-0569_SSA_7.27.2018.docx Supporting Statement A	2018-07-27
(5) Justification for SSN (2656).pdf Supplementary Document	2018-07-25

IC Document Collections

IC ID	Document Title	Status
229237	Data For Payment of Retired Personnel Form and Instruction	Modified

ICR Details

OMB Control No: 0704-0569	ICR Reference No: 201807-0704-004
Status: Historical Active	Previous ICR Reference No: 201711-0704-002
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Data for Payment of Retired Personnel
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/11/2018
	Date Received in OIRA: 07/27/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved	09/30/2018
Responses	66,800	0	65,000
Time Burden (Hours)	16,700	0	16,250
Cost Burden (Dollars)	440,212	0	428,025

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Abstract: To collect information needed to establish a retired/retainer pay account for members of the Uniformed Services who are retiring or reaching the age of eligibility to receive retired pay. This includes designation of beneficiaries for unpaid retired pay, state tax withholding election, lump sum of retired pay election, information on dependents, and election of Survivor Benefit Plan coverage.

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Authorizing Statute(s): US Code: 10 USC Section 1415 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 23440	05/21/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 35625	07/27/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Data For Payment of Retired Personnel	DD Form 2656	Data for Payment of Retired Pay

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	66,800	65,000	0	1,800	0	0
Annual Time Burden (Hours)	16,700	16,250	0	450	0	0
Annual Cost Burden (Dollars)	440,212	428,025	0	12,187	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: OMB Control Number 0704-0569 was approved on January 2, 2018, for emergency use. Since approval, the Coast Guard asked to use the same form for its retiring members. Approximately 1,800 Coast Guard members retire each year, which increased the annual, approximate burden from 65,000 applicants to 66,800.

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Annual Cost to Federal Government: $340,012

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/27/2018

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