View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	TRICARE Young Adult Application	Agency IC Tracking Number:	0720-0049

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
Other-Screenshots					Yes	Yes	Fillable Fileable
Form and Instruction	DD2947-1				Yes	Yes	Fillable Fileable
Form and Instruction	DD2497-2				Yes	Yes	Fillable Fileable
Form and Instruction	DD2947-3				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title: TRICARE YOUNG ADULT APPLICATION	FR Citation: 89 FR 63422

Number of Respondents: 7,164	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 82 %

	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	7,164	0	4,455	0	0	2,709
Annual IC Time Burden (Hours)	1,791	0	1,114	0	0	677
Annual IC Cost Burden (Dollars)	12,967	0	8,064	0	0	4,903

Documents for IC

Title	Document	Date Uploaded
Beneficary Web Enrollment Welcome Screen		04/11/2025

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

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.