In accordance
with 5 CFR 1320, this information collection is disapproved. The
agency submitted their last supporting statement. It is incorrect.
The agency may re-submit the collection immediately with a new,
correct supporting statement.
Inventory as of this Action
Requested
Previously Approved
01/31/2010
36 Months From Approved
11/30/2010
200
0
200
200
0
200
4,400
0
4,400
The information collection requirement
is necessary to ensure that applicants for CHAMPUS-Provider Status
meet the conditions for authorization as a CHAMPUS Corporate
Services Provider. The collected nformation will be used by CHAMPUS
contractors to process claims and verify authorization
status.
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.