View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0720-0055	ICR Reference No: 202205-0720-001
Status: Historical Inactive	Previous ICR Reference No: 201908-0720-002
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: Third Party Collection Program (Insurance Information)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 10/17/2022
	Date Received in OIRA: 09/08/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2022	36 Months From Approved	10/31/2022
Responses	5,910,000	0	5,910,000
Time Burden (Hours)	394,000	0	394,000
Cost Burden (Dollars)	10,933,500	0	10,933,500

Annual Cost to Federal Government: $8,159,015

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Terry McDavid 703 681-3645 terry.a.mcdavid.civ@mail.mil

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