Fsr 181 Dod Tricare

Customer Satisfaction Measure of Government Websites

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0186 can be found here:

Documents and Forms

Document Name Document Type
Form FSR 181 DOD TRICAR FSR 181 DOD TRICARE Form
FSR 181 DOD TRICAR FSR 181 DOD TRICARE TRICARE Custom Questions for OMB.xls Form

Information Collection (IC) Details

IC Title:	FSR 181 DOD TRICARE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form	FSR 181 DOD TRICARE	FSR 181 DOD TRICARE	TRICARE Custom Questions for OMB.xls		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	208	208
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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