DIAGNOTIC EVALUATION, PROGRAM FOR THE HANDICAPPED

ICR 198307-0704-005

OMB: 0704-0098

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
108650 Migrated
ICR Details
0704-0098 198307-0704-005
Historical Active 197809-0704-004
DOD/DODDEP
DIAGNOTIC EVALUATION, PROGRAM FOR THE HANDICAPPED
Revision of a currently approved collection   No
Regular
Approved without change 09/28/1983
Retrieve Notice of Action (NOA) 07/20/1983
  Inventory as of this Action Requested Previously Approved
09/30/1986 09/30/1986 09/30/1983
840 0 3,500
840 0 7,000
0 0 0

PUBLIC LAW 89-614 (MILITARY MEDICAL BENEFITS AMENDMENTS OF 1966) REQUIRES A PERIODIC REVIEW (BUT AT LEAST ANNUALLY) ON ALL CASES IN WHICH A BENEFICIARY IS RECEIVING BENEFITS UNDER THE PROGRAM FOR THE HANDICAPPED. USED TO OBTAIN INFORMATION AS TO WHETHER TREATMENT OR SERVICES PROVIDED HAVE BEEN HELPFUL, ECONOMICAL, AND EFFECTIVE.

None
None


No

1
IC Title Form No. Form Name
DIAGNOTIC EVALUATION, PROGRAM FOR THE HANDICAPPED CHAMPUS, 141

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 840 3,500 0 0 -2,660 0
Annual Time Burden (Hours) 840 7,000 0 0 -6,160 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/20/1983


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