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: 0720-0006	ICR Reference No: 200301-0720-001
Status: Historical Active	Previous ICR Reference No: 199908-0720-001
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: CHAMPUS Claims Patient's Request for Medical Payment
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2003
	Date Received in OIRA: 01/30/2003
Terms of Clearance: Approved as a reinstatement. This collection expired in September 2002 and has been in use by DoD without a valid OMB number in violation of the Paperwork Reduction Act. In the future DoD should take care to ensure that all information collections are conducted under a valid OMB number.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2006	03/31/2006
Responses	1,035,000	0	0
Time Burden (Hours)	258,750	0	0
Cost Burden (Dollars)	0	0	0

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