OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

TRICARE Retail Refunds Request User Account Access

IC 5612 under ICR 202511-0720-004 · OMB 0720-0032.

Documents and Forms
Document Name
Document Type
Other-Online system
Other-Online system
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

TRICARE Retail Refunds Request User Account Access
 
No Unchanged
 
Voluntary
 
32 CFR 199.21

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Online system TRRWS User Account Access screenshots_2022.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

300 0
   
Private Sector Businesses or other for-profits
 
   100 %

  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 1,200 0 0 0 0 1,200
Annual IC Time Burden (Hours) 9,600 0 0 0 0 9,600
Annual IC Cost Burden (Dollars) 474,240 0 0 0 0 474,240

Title Document Date Uploaded
Privacy Advisory and ADN Screenshot TRRWS Homepage 9.23 v2.pdf 09/30/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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