Information Collection

Health Care Survey of DoD Beneficiaries (HCSDB)

IC 264497 under ICR 202401-0720-001 · OMB 0720-0078.

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

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 Agency Discretion
Annual Number of Responses for this IC	24,200	24,200
Annual IC Time Burden (Hours)	6,050	6,050
Annual IC Cost Burden (Dollars)	160,204	160,204

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.