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Health Care Survey of DoD Beneficiaries (HCSDB)
The Health Care Survey of DoD Beneficiaries (HCSDB)
OMB: 0720-0078
IC ID: 264497
OMB.report
DOD/DODOASHA
OMB 0720-0078
ICR 202401-0720-001
IC 264497
( )
Documents and Forms
Document Name
Document Type
HCSDB_FY24Q1 Survey Instrument.pdf
Other-Survey
HCSDB_FY24_Q3_SPD-15 update_2024_05_01.docx
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Health Care Survey of DoD Beneficiaries (HCSDB)
Agency IC Tracking Number:
0720-HCSD
Is this a Common Form?
No
IC Status:
New
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
Other-Survey
HCSDB_FY24_Q3_SPD-15 update_2024_05_01.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
24,200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
86 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
24,200
0
24,200
0
0
0
Annual IC Time Burden (Hours)
6,050
0
6,050
0
0
0
Annual IC Cost Burden (Dollars)
160,204
0
160,204
0
0
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.