Proposed Collection; Comment Request

DEPARTMENT OF DEFENSE

Office of the Secretary

Proposed Collection; Comment Request

AGENCY: Office of the Under Secretary of Defense (Personnel and

Readiness), DoD.

ACTION: Notice.

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In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction

Act of 1995, the Office of the Under Secretary of Defense (Personnel

and Readiness) announces the following proposed establishment of DD

Form X376, ``Report of Medical History,'' a public information

collection, and seeks public comment for the provisions thereof.

Comments are invited on: (a) whether the proposed collection of

information is necessary for the proper performance of the functions to

the agency, including whether the information shall have practical

utility; (b) the accuracy of the agency's estimate of burden of the

proposed information collection; (c) ways to enhance the quality,

utility, and clarity of the information to be collected; and (d)

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ways to minimize the burden of the information collection on

respondents, including use of automated collection techniques or other

forms of information technology.

DATES: Consideration will be given to all comments received by February

16, 1999.

ADDRESSES: Written comments and recommendations on the proposed

information collection should be sent to the Office of the Under

Secretary of Defense (Personnel and Readiness) (Force Management

Policy) (Military Personnel Policy) /Accession Policy, ATTN: LTC

Michael Ostroski, Room 2B271, 4000 Defense Pentagon, Washington, DC

20301-4000.

FOR FURTHER INFORMATION CONTACT: To request more information on this

proposed information collection or to obtain a copy of the proposal and

associated collection instruments, please write to the above address or

call (703) 695-5529.

Title, Associated Form, and OMB Number: ``Report of Medical

History,'' DD Form X376, OMB Control Number 0704-[To be Determined].

Needs and Uses: Title 10, USC Chapter 31: Section 504 and 505, and

Chapter 33: Section 532, requires applicants to meet accession medical

standards prior to enlistment into the Armed Forces (including the

Coast Guard). If applicants' medical history reveals a medical

condition that does not meet the accession medical standards, they are

medically disqualified for military entrance. This form also will be

used by all Service members not only in their initial medical

examination but also for required periodic medical examinations.

Affected Public: Individuals or households

Annual Burden Hours: 256,659

Number of Respondents: 330,000

Responses Per Respondent: 1

Average Burden Per Response: .66 hours per respondent.

Frequency: One time.

SUPPLEMENTAL INFORMATION:

Summary of Information Collection

The new form associated with this information collection will

replace the form currently used by the Department, ``SF 93--Report of

Medical History.'' This new form is needed in order to obtain the

medical information which affects entrance physical examinations,

routine in-service physical examinations, separation physical

examinations, and other medical examinations, as required.

The respondents are all applicants for enlistment, induction or

commissioning. The applicant(s) completes the medical history

information recorded on the form. This information collected provides

the Armed Services with the medical history of applicants. The DD Form

X376 is the method of collecting and verifying medical data on

applicants applying for entrance. This DD Form X376 will be the

official DoD medical document used by the Services through which

historical medical information is collected, reviewed, and maintained.

Dated: December 9, 1998.

Patricia L. Toppings,

Alternate OSD Federal Register Liaison Officer, Department of Defense.

[FR Doc. 98-33131 Filed 12-14-98; 8:45 am]

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