Submission for OMB Review; Comment Request

---
identifier: "/us/fr/2019-18624"
source: "fr"
legal_status: "authoritative_unofficial"
title: "Submission for OMB Review; Comment Request"
title_number: 0
title_name: "Federal Register"
section_number: "2019-18624"
section_name: "Submission for OMB Review; Comment Request"
positive_law: false
currency: "2019-08-29"
last_updated: "2019-08-29"
format_version: "1.1.0"
generator: "[email protected]"
agency: "Defense Department"
document_number: "2019-18624"
document_type: "notice"
publication_date: "2019-08-29"
agencies:
  - "Defense Department"
  - null
fr_citation: "84 FR 45475"
fr_volume: 84
docket_ids:
  - "Docket ID: DoD-2019-HA-0075"
comments_close_date: "2019-09-30"
fr_action: "30-Day information collection notice."
---


#  Submission for OMB Review; Comment Request

**AGENCY:**

Office of the Assistant Secretary of Defense for Health Affairs, DoD.

**ACTION:**

30-Day information collection notice.

**SUMMARY:**

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.

**DATES:**

Consideration will be given to all comments received by September 30, 2019.

**ADDRESSES:**

Comments and recommendations on the proposed information collection should be emailed to Mr. Josh Brammer, DoD Desk Officer, at *[email protected].* Please identify the proposed information collection by DoD Desk Officer, Docket ID number, and title of the information collection.

**FOR FURTHER INFORMATION CONTACT:**

Angela James, 571-372-7574, or *[email protected].*

**SUPPLEMENTARY INFORMATION:**

*Title; Associated Form; and OMB Number:* Application for Champus Provider Status: Corporate Services Provider, DD Form 3030, 0720-0020.

*Type of Request:* Extension.

*Number of Respondents:* 335.

*Responses per Respondent:* 1.

*Annual Responses:* 335.

*Average Burden per Response:* 20 minutes.

*Annual Burden Hours:* 112.

*Needs and Uses:* This information collection requirement is necessary to ensure that the conditions are met for authorization as a TRICARE/CHAMPUS Corporate Service Provider. Respondents are freestanding corporations and foundations seeking authorization under the TRICARE/CHAMPUS program to provide otherwise covered professional services to eligible TRICARE/CHAMPUS beneficiaries.

*Affected Public:* Business or other for-profit.

*Frequency:* As required.

*Respondent's Obligation:* Voluntary.

*OMB Desk Officer:* Mr. Josh Brammer.

You may also submit comments and recommendations, identified by Docket ID 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 ID 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. Angela James.

Requests for copies of the information collection proposal should be sent to  Ms. James at *[email protected].*

Dated: August 23, 2019.

Aaron T. Siegel,

Alternate OSD 

                         Liaison Officer, Department of Defense.