Submission for OMB Review; Comment Request

[Federal Register Volume 62, Number 244 (Friday, December 19, 1997)]
[Notices]
[Page 66604]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-33112]


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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).
    Title, Associated Form, and OMB Number: TRICARE Retiree Dental 
Program enrollment Form; Contractor Designed Format (No DD Form 
Number); OMB Number 0720-0015.
    Type of request: Extension.
    Number of Respondents: 286,570.
    Responses per Respondent: 1.
    Annual Responses: 286,570.
    Average Burden per response: 15 minutes.
    Annual Burden Hours: 71,640.
    Needs and Uses: Conditional approval for the information collection 
was granted under OMB approval number 0720-0015 pending development of 
a contractor designed enrollment form which is being submitted for 
approval. The form will be submitted to OMB concurrently with 
publication of the final rule. The collection instrument serves as an 
application form for military members entitled to retired pay and 
eligible dependents to enroll in the TRICARE Retiree Dental Program. 
The enrollment application will allow the Department to collect the 
information necessary to properly identify the program's applicants and 
to determine their eligibility for enrollment in the TRICARE Retiree 
Dental Program. In completing and signing an enrollment form, 
applicants will acknowledge that they understand the benefits offered 
under the program and the rules they must follow to continue their 
participation in the program. Further, applicants will acknowledge that 
the premium will be withheld from retired pay when such pay is 
available. Initial enrollment will be for a period of 24 months 
followed by month to month enrollment as long as the enrollee chooses 
to continue enrollment.
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondent's Obligation: Required to obtain or retain benefits.
    OMB Desk Officer: Ms. Allison Eydt.
    Written comments and recommendations on the proposed information 
collection should be sent to Ms. Eydt at the Office of Management and 
Budget, Desk Officer for DoD/Health Affairs, Room 10235, New Executive 
Office Building, Washington, DC 20503.
    DOD Clearance Officer: Mr. Robert Cushing.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Cushing, WHS/DIOR, 1215 Jefferson Davis Highway, 
Suit 1204, Arlington, VA 22202-4302.

    Dated: December 15, 1997.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 97-33112 Filed 12-18-97; 8:45 am]
BILLING CODE 5000-04-M