Document
Submission for OMB Review; Comment Request
The DoD has submitted to the Office of Management and Budget (OMB) for clearance the following proposal for collection of information under the provisions of the Paperwork Reduc...
SUPPLEMENTARY INFORMATION:
Title; Associated Form; and OMB Number:
Personnel Accountability and Assessment for a Public Health Emergency; DD Form 3112; OMB Control Number: 0720-0067.
Type of Request:
Extension.
Number of Respondents:
100,000.
Responses per Respondent:
1.
Annual Responses:
100,000.
Average Burden per Response:
5 minutes.
Annual Burden Hours:
8,333.3 hours.
Needs and Uses:
The principal purpose of the DD Form 3112, “Personnel Accountability and Assessment Notification for a Public Health Emergency,” is to collect information used to protect the health and safety of individuals working in, residing on, or assigned to DoD installations, facilities, field operations, and commands, and to protect the DoD mission. When authorized by DoD, this form may be used to provide information about individuals who are infected or otherwise impacted by a public health emergency or similar occurrence or when there is an isolated incident in which an individual learns they have been exposed to a contagious disease or hazardous substance/agent. The form will also be used to document personnel accountability for and status of DoD-affiliated personnel in a natural or man-made disaster, or when directed by the Secretary of Defense. Such events could include severe weather events, acts of terrorism or severe destruction. The collection of this information is necessary to support the DoD in protecting the health and safety of DoD-affiliated individuals and maintain the DoD mission.
The information collected will inform decisions made about the status of DoD facilities and spaces that Affected Individuals have entered. This information may be used to make decisions to protect the health and safety of DoD personnel and facilities. It may also be used to notify other individuals who may have contacted the Affected Individual to make informed decisions about the status of the DoD facility and office space that subject individuals exposed to communicable diseases or hazardous substances/agents have entered. This information may be used to make Health Protection Condition (HPCON) level decisions. It may also be used to notify other individuals who may have been in contact with the subject individual(s).
Affected Public:
Individuals or households.
Frequency:
On occasion.
Respondent's Obligation:
Voluntary.
OMB Desk Officer:
Mr. Matt Eliseo.
You may also submit comments and recommendations, identified by Docket ID number and title, by the following method:
Instructions:
All submissions received must include the agency name, Docket ID number, and title for this
Federal Register
document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the internet at
http://www.regulations.gov
as they are received without change, including any personal identifiers or contact information.
DOD Clearance Officer:
Ms. Angela Duncan.
Requests for copies of the information collection proposal should be sent to Ms. Duncan at
whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.
Dated: January 3, 2024.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.