Pharmacy Redesign Pilot Program

ICR 200005-0720-001

OMB: 0720-0023

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
5598 Migrated
ICR Details
0720-0023 200005-0720-001
Historical Active 200003-0720-001
DOD/DODOASHA
Pharmacy Redesign Pilot Program
Extension without change of a currently approved collection   No
Regular
Approved without change 07/14/2000
Retrieve Notice of Action (NOA) 05/12/2000
  Inventory as of this Action Requested Previously Approved
07/31/2003 07/31/2003 09/30/2000
2,000 0 2,000
333 0 333
0 0 0

The Pharmacy Redesign Pilot Program adheres to the requirements in the Strom Thurmond National Defense Authorization Act for FY99, Section 723. The collection instrument serves as an application form for enrollment in the Pharmacy Redesign Pilot Program. The information collected will be used to provide contractors with the data to determine eligibility, other health insurance liability and premium payment.

None
None


No

1
IC Title Form No. Form Name
Pharmacy Redesign Pilot Program DD-2814

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,000 2,000 0 0 0 0
Annual Time Burden (Hours) 333 333 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/12/2000


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