Information Collection

Sd 816

IC 5521 under ICR 202604-0704-003 · OMB 0704-0425.

Documents and Forms

Document Name Document Type
Form SD 816 Application for Department of Defense Impact Aid for Children with Severe Disabilities SD 816 Form
SD 816 Application for Department of Defense Impact Aid for Chi SD816 - DoD Impact Aid Application (May 2023).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SD 816	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SD 816	Application for Department of Defense Impact Aid for Children with Severe Disabilities	SD816 - DoD Impact Aid Application (May 2023).pdf		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: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	-50	150
Annual IC Time Burden (Hours)	350	-51	401
Annual IC Cost Burden (Dollars)	22,284	7,634	14,650

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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