TRICARE Prime Enrollment/Disenrollment Applications

TRICARE Prime Enrollment/Disenrollment Applications

OMB: 0720-0008

IC ID: 5574

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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TRICARE Prime Enrollment/Disenrollment Applications
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form X404 No No
Form X443 No No


    

20,689 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 20,689 0 20,689 0 0 0
Annual IC Time Burden (Hours) 2,150 0 2,150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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