Champus Choice Enrollment Form

CHAMPUS CHOICE ENROLLMENT FORM

OMB: 0704-0162

IC ID: 165235

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CHAMPUS CHOICE ENROLLMENT FORM
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CHAMPUS 606 No No


    

3,590 0
   
Individuals or Households
 
   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 3,590 0 2,790 0 0 800
Annual IC Time Burden (Hours) 538 0 274 0 0 264
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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