TRICARE Young Adult Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0720-0049 can be found here:

Documents and Forms

Document Name Document Type
Beneficiary Web Enrollment Welcome Screen.pdf www.dmdc.osd.mil/appj/bwe/indexAction.do;jsessionid=Qx3x63ey1jUwW94oZ3ZekwRumxOExFu5eGtCsnspVb0ETeO2dq4b!-138697852 Instruction
DD-2947-1 TRICARE Young Adult Application dd2947-1 draft 20180927 locked.pdf Form and Instruction
DD-2947-2 TRICARE Young Adult Application dd2947-2 draft 20180927 locked.pdf Form and Instruction
DD-2947-3 TRICARE Young Adult Application dd2947-3 draft 20180927 locked.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	TRICARE Young Adult Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Instruction			Beneficiary Web Enrollment Welcome Screen.pdf	https://www.dmdc.osd.mil/appj/bwe/indexAction.do;jsessionid=Qx3x63ey1jUwW94oZ3ZekwRumxOExFu5eGtCsnspVb0ETeO2dq4b!-138697852	Yes	Yes	Fillable Fileable Signable
Form and Instruction	DD-2947-1	TRICARE Young Adult Application	dd2947-1 draft 20180927 locked.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	DD-2947-2	TRICARE Young Adult Application	dd2947-2 draft 20180927 locked.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	DD-2947-3	TRICARE Young Adult Application	dd2947-3 draft 20180927 locked.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,709	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 21 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,709	-32,000	2,709	32,000
Annual IC Time Burden (Hours)	677	-8,000	677	8,000
Annual IC Cost Burden (Dollars)	4,903	0	4,903	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.