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TRICARE Select Enrollment, Disenrollment, and Change Form
TRICARE Select Enrollment, Disenrollment, and Change Form
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TRICARE Select Enrollment, Disenrollment, and Change Form
OMB: 0720-0061
OMB.report
DOD/DODOASHA
OMB 0720-0061
ICR 201806-0720-001
IC 229387
TRICARE Select Enrollment, Disenrollment, and Change Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0720-0061 can be found here:
2024-09-24 - Revision of a currently approved collection
2021-08-12 - Extension without change of a currently approved collection
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TRICARE Select Enrollment, Disenrollment and Change Form
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