View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0720-0013	ICR Reference No: 200201-0720-002
Status: Historical Active	Previous ICR Reference No: 199704-0720-001
Agency/Subagency: DOW/DODOASHA	Agency Tracking No:
Title: Health Insurance Claim Form, HCFA 1450
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/26/2002
	Date Received in OIRA: 01/24/2002
Terms of Clearance: This collection expired in June 2000 and has been in use without an OMB number since that time. This is a violation of the Paperwork Reduction Act and must be reported as a violation in the next ICB. In the future, DoD should take great care to ensure that all information collections have current OMB approvals as required under the PRA.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2005	03/31/2005
Responses	2,100,000	0	0
Time Burden (Hours)	525,000	0	0
Cost Burden (Dollars)	859,000	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	2,100,000	2,100,000
Annual Time Burden (Hours)	525,000	525,000
Annual Cost Burden (Dollars)	859,000	859,000

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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