Information Collection

2020 043 Survey Mapping Document DHA Tricare MTF survey

IC 244431 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⚠️ Notice: This information collection may be referencing outdated material.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 043 2020 043 Survey Mapping Document DHA Tricare MTF survey	Form and Instruction
043 2020 043 Survey Mapping Document DHA Tricare MTF survey 2020 043 Survey Mapping Document DHA Tricare MTF survey.docx	Form and Instruction
1090-0008 Generic Clearance Request Form MTF Feedback survey - DHA Tricare - signed.pdf 1090-0008 Generic Clearance Request Form MTF Feedback survey - DHA Tricare - signed	IC Document
1090-0008 Feedback Survey Mapping Doc DHA Tricare MTF survey.xlsx 1090-0008 Feedback Survey Mapping Doc DHA Tricare MTF survey	IC Document

IC Title:

2020 043 Survey Mapping Document DHA Tricare MTF survey

Agency IC Tracking Number:

043

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	043	2020 043 Survey Mapping Document DHA Tricare MTF survey	2020 043 Survey Mapping Document DHA Tricare MTF survey.docx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	500	500
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1090-0008 Generic Clearance Request Form MTF Feedback survey - DHA Tricare - signed	1090-0008 Generic Clearance Request Form MTF Feedback survey - DHA Tricare - signed.pdf	11/09/2020
1090-0008 Feedback Survey Mapping Doc DHA Tricare MTF survey	1090-0008 Feedback Survey Mapping Doc DHA Tricare MTF survey.xlsx	11/09/2020

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