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Military Health Care Survey (includes Pilot Test Of Champus Prepaid Health Benefit Demonstration)
MILITARY HEALTH CARE SURVEY (INCLUDES PILOT TEST OF CHAMPUS PREPAID HEALTH BENEFIT DEMONSTRATION)
OMB: 0790-0002
IC ID: 109256
OMB.report
DOD/OS
OMB 0790-0002
ICR 198307-0790-001
IC 109256
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MILITARY HEALTH CARE SURVEY (INCLUDES PILOT TEST OF CHAMPUS PREPAID HEALTH BENEFIT DEMONSTRATION)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10,080
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
10,080
0
10,080
0
0
0
Annual IC Time Burden (Hours)
6,744
0
6,744
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.