Police Center Records (POLC)

Forms and Documents

Document Name	Status
DODI 6055.17p.pdf Supplementary Document	2014-02-03
7e - S500-43.pdf Supplementary Document	2014-02-03
7d - S500-42.pdf Supplementary Document	2014-02-03
7c - S500-41.pdf Supplementary Document	2014-02-03
7b - S500-40.pdf Supplementary Document	2014-02-03
7a - S500-30.pdf Supplementary Document	2014-02-03
DoDI 5505.17p.pdf Supplementary Document	2014-02-03
PIA Sec 1-2.pdf Supplementary Document	2014-02-03
5 - MFR_POLICE CENTER SSN Justif.pdf Supplementary Document	2014-02-03
Supporting Statement - Revised (April 14).docx Supporting Statement A	2014-04-30

IC Document Collections

IC ID	Document Title	Status
210253	Incident Report Form/System Other-System Notices	New

ICR Details

OMB Control No: 0704-0514	ICR Reference No: 201402-0704-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Police Center Records (POLC)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/05/2014
	Date Received in OIRA: 02/05/2014
Terms of Clearance: This collection is approved based on the revised materials provided by the Department. DOD must report this collection as a violation in the Information Collection Budget.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved
Responses	220	0	0
Time Burden (Hours)	110	0	0
Cost Burden (Dollars)	3,208	0	0

---

Abstract: Records on persons who have committed or are suspected of having committed, any criminal act (felony or misdemeanor) or any violation of law, regulation, or ethical standards on DLA controlled activities or facilities; or outside of those areas in cases where DLA is or may be a party of interest.

---

Authorizing Statute(s): PL: Pub.L. 108 - 494 102 Name of Law: null
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 31899	05/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 4337	01/27/2014
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Incident Report Form/System	DLA 635	Incident Report

---

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	220	0	0	0	0	220
Annual Time Burden (Hours)	110	0	0	0	0	110
Annual Cost Burden (Dollars)	3,208	0	0	0	0	3,208

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $124,830

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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

---

Common Form ICR:  No

---

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: 02/05/2014

---