Information Collection

Program Information Institutional Providers - Champus

IC 165202 under ICR 198609-0704-010 · OMB 0704-0092.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PROGRAM INFORMATION INSTITUTIONAL PROVIDERS - CHAMPUS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	OCHAMPUS	No	No
Form	FORM 200	No	No
Form	B, C, E, F	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	1,100	900
Annual IC Time Burden (Hours)	2,000	1,100	900
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.