[Federal Register Volume 70, Number 127 (Tuesday, July 5, 2005)]
[Notices]
[Pages 38661-38662]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-13102]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Submission for OMB review; Comment Request

ACTION: Notice.

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    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).

DATES: Consideration will be given to all comments received by August 
4, 2005.
    Title, Form, and OMB Number: TRICARE Plus Enrollment Application, 
DD Form 2853 and TRICARE Plus Disenrollment Request, DD Form 2854; OMB 
Number 0720-0028.
    Type of Request: Extension.
    Number of Respondents: 14,289.
    Responses per Respondent: 1.
    Annual Responses: 14,289.
    Average Burden per Response: 7 minutes for DD Form 2853 and 5 
minutes for DD Form 2854.
    Annual Burden Hours: 1,536.
    Needs and Uses: These forms serve as an application for enrollment 
and disenrollment in the Department of Defense's TRICARE Plus Health 
Plan established in accordance with title 10 U.S.C. 1099 (which calls 
for a health care enrollment system) and 1086 (which authorizes TRICARE 
eligibility of Medicare Eligible Persons and has resulted in the 
development of a new enrollment option called TRICARE Plus). The 
information collected provides the TRICARE contractors with necessary 
data to determine beneficiary eligibility and to identify the selection 
of a health care option.
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondent's Obligation: Required to obtain or retain benefits.
    OMB Desk Officer: Mr. John Kramer. Written comments and 
recommendations on the proposed information collection should be sent 
to Mr. Kraemer at the Office of Management and Budget, Desk Officer for 
DoD, Room 10236, New Executive Office Building, Washington, DC 20503.

[[Page 38662]]

    DOD Clearance Officer: Ms. Patricia Toppings. Written requests for 
copies of the information collection proposal should be sent to Ms. 
Toppings, WHS/ESD/Information Management Division, 1225 South Clark 
Street, Suite 504, Arlington, VA 22202-4326.

    Dated: June 27, 2005.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 05-13102 Filed 7-1-05; 8:45 am]
BILLING CODE 5001-06-M