[Federal Register Volume 59, Number 154 (Thursday, August 11, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-19552] [[Page Unknown]] [Federal Register: August 11, 1994] ----------------------------------------------------------------------- DEPARTMENT OF DEFENSE Public Information Collection Requirement Submitted to the Office of Management and Budget (OMB) for Review ACTION: Notice. ----------------------------------------------------------------------- The Department of Defense has submitted to OMB for clearance, the following proposal for collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35). Title, Applicable Form, And OMB Control Number: Statement of Personal Injury--Possible Third Party Liability--CHAMPUS; DD Form 2527; OMB Control Number 0720-0003 Type of Request: EXPEDITED PROCESSING--Approval date requested: 30 days following publication in the Federal Register Number of Respondents: 32,500 Responses Per Respondent: 1 Annual Responses: 32,500 Average Burden Per Response: 13.8 minutes Annual Burden Hours: 7,475 Needs and Uses: The Statement of Personal Injury--Possible Third Party Liability Form is completed by CHAMPUS beneficiaries suffering from personal injuries and receiving medical care at Government expense. The information collected hereby is utilized in the assertion of the Government's right to recovery under the Federal Medical Care Recovery Act. It is used in the evaluation and processing of recovery claims. Affected Public: Individuals or households, Federal agencies or employees Frequency: On occasion Respondent's Obligation: Required to obtain or retain a benefit OMB Desk Officer: Ms. Shannah Koss Written comments and recommendations on the proposed information collection should be sent to Ms. Koss at the Office of Management and Budget, Desk Officer for DoD, Room 10235, New Executive Office Building, Washington, DC 20503 DoD Clearance Officer: Mr. William P. Pearce. Written requests for copies of the information collection proposal should be sent to Mr. Pearce, WHS/DIOR, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302 Dated: August 5, 1994. Patricia L. Toppings, Alternate OSD Federal Register Liaison Officer, Department of Defense. BILLING CODE 5000-04-M![]()
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TN11AU94.003 [FR Doc. 94-19552 Filed 8-10-94; 8:45 am] BILLING CODE 5000-04-C