Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
TRICARE Prime Enrollment/Disenrollment Applications Modified 72905 22321 0 Form and Instruction DD Form 2876 TRICARE Prime Enrollment Application and PCM Change Form
Other-Enrollment Screen Views
Form and Instruction DD Form 2877 TRICARE Prime Disenrollment Applicaation
Other-Disenrollment Screen Views
Total burden requested under this ICR: 72905 22321 0  
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