# Submission for OMB Review; Comment Request
**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).
**DATES:**
Consideration will be given to all comments received by December 30, 2005.
*Title and OMB Number:* TRICARE Dental Program (TDP) Claim Form, OMB Number 0720-0035.
*Type of Request:* Extension.
*Number of Respondents:* 56,512.
*Responses Per Respondent:* 62.
*Annual Responses:* 3,503,744.
*Average Burden Per Response:* 15 minutes.
*Annual Burden Hours:* 875,936.
*Needs and Uses:* The TDP claim form is required to gather information to make payment for legitimate dental claims and to assist in contractor surveillance and program integrity investigations and to audit financial transactions where the Department of Defense has a financial stake. The information from the claim form is also used to provide important cost share explanations to the beneficiary.
*Affected Public:* Business or other for-profit.
*Frequency:* On Occasion.
*Respondent's Obligation:* Voluntary.
*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 Health, Room 10102, New Executive Office Building, Washington, DC 20503.
*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, 1777 North Kent Street, RPN, Suite 11000, Arlington, VA 22209-2133.
Dated: November 22, 2005.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.