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Pilot Test Of Champus Prepaid Health Benefit Demonstration - Employer Health Benefit Form

IC 108763 under ICR 198211-0704-003 · OMB 0704-0165.

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PILOT TEST OF CHAMPUS PREPAID HEALTH BENEFIT DEMONSTRATION - EMPLOYER HEALTH BENEFIT FORM
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability


    

144 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 144 0 0 0 0 144
Annual IC Time Burden (Hours) 24 0 0 0 0 24
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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