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: 0704-0364	ICR Reference No: 200205-0704-004
Status: Historical Active	Previous ICR Reference No: 199905-0704-001
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Continued Health Care Benefit Program (CHCBP) Application
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2002
	Date Received in OIRA: 05/01/2002
Terms of Clearance: DoD is encouraged to automate this web-available form to make it transactional when e-authentication and e-payment tools are available, certainly prior to the next request for extension in 3 years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2005	06/30/2005	06/30/2002
Responses	808	0	600
Time Burden (Hours)	202	0	150
Cost Burden (Dollars)	0	0	0

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