Information Collection

Restructure or Realignment of Military Medical Treatment Facilities

IC 262646 under ICR 202310-0720-001 · OMB 0720-0073.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MAX Survey - Restructure or Realignment of MTFs_9.12.2023.pdf surveys.max.gov/688749?lang=en	Other-
MAX Survey - Restructure or Realignment of MTFs_9.12.2023.pdf surveys.max.gov/688749?lang=en	Other-

IC Title:

Agency IC Tracking Number:

0720-RMTF

Is this a Common Form? No

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
Other-			MAX Survey - Restructure or Realignment of MTFs_9.12.2023.pdf	https://surveys.max.gov/688749?lang=en	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53,100

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	106,200	106,200
Annual IC Time Burden (Hours)	17,700	17,700
Annual IC Cost Burden (Dollars)	526,752	526,752

Documents for IC

table that charts IC Documents
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.