[Federal Register Volume 77, Number 245 (Thursday, December 20, 2012)]
[Notices]
[Page 75413]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-30663]



[[Page 75413]]

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket No. DOD-2009-HA-0159]


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 January 
22, 2013.
    Title and OMB Number: TRICARE Prime Enrollment, Disenrollment, and 
Primary Care Manager (PCM) Change Form; DD Form 2876; OMB Control 
Number 0720-0008.
    Type of Request: Revision.
    Number of Respondents: 72,905.
    Responses per Respondent: 1.
    Annual Responses: 72,905.
    Average Burden per Response: 18.367 minutes.
    Annual Burden Hours: 22,317.
    Needs and Uses: This collection instrument serves as applications 
for the Enrollment, Primary Care Manager (PCM) Change and Disenrollment 
for the Department of Defense's TRICARE Prime program established in 
accordance with title 10 U.S.C. 1099 (which calls for a healthcare 
enrollment system). Monthly payment options for retiree enrollment fees 
for TRICARE Prime are established in accordance with title 10 U.S.C. 
1097a(c).
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondent's Obligation: Required to obtain or retain benefits.
    OMB Desk Officer: Mr. John Kraemer.
    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.
    You may also submit comments, identified by docket number and 
title, by the following method:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
Internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.
    DOD Clearance Officer: Ms. Patricia Toppings.
    Written requests for copies of the information collection proposal 
should be sent to Ms. Toppings at WHS/ESD Information Management 
Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, 
VA 22350-3100.

    Dated: November 21, 2012.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2012-30663 Filed 12-19-12; 8:45 am]
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