Information Collection

2019 008 TRICARE_Feedback Survey

IC 233990 under ICR 201805-1090-003 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 008 2019 008 TRICARE_Feedback Survey	Form and Instruction
008 2019 008 TRICARE_Feedback Survey 2019 008 TRICARE_Feedback Survey.xlsx 2019 008 TRICARE_Feedback Survey	Form and Instruction
1090-0008 Survey Mapping Document_TRICARE Open Season Feedback Survey .docx 1090-0008 Survey Mapping Document_TRICARE Open Season Feedback Survey	IC Document
TRICARE Open Season Feedback 1090-0008 Clearance Request Form.pdf TRICARE Open Season Feedback 1090-0008 Clearance Request Form	IC Document

IC Title:

2019 008 TRICARE_Feedback Survey

Agency IC Tracking Number:

008

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	008	2019 008 TRICARE_Feedback Survey	2019 008 TRICARE_Feedback Survey.xlsx	2019 008 TRICARE_Feedback Survey	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: 3,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1090-0008 Survey Mapping Document_TRICARE Open Season Feedback Survey	1090-0008 Survey Mapping Document_TRICARE Open Season Feedback Survey .docx	11/09/2018
TRICARE Open Season Feedback 1090-0008 Clearance Request Form	TRICARE Open Season Feedback 1090-0008 Clearance Request Form.pdf	11/09/2018

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