View Information Collection (IC)

View Information Collection (IC)

IC Title:	Professional Qualifictions, Medical and Peer Reviewers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	CHAMPUS FORM 780	Professional Qualifications Medical/Peer Reviewers	CHAMPUSFORM780.pdf		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	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	60	0	0	0	0	60
Annual IC Time Burden (Hours)	15	0	0	0	0	15
Annual IC Cost Burden (Dollars)	750	0	0	750	0	0

Documents for IC

Title	Document	Date Uploaded
TRICARE Operations Manual 6010.15-M	OPS MANUAL 6010.51 CH13.pdf	08/31/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.