[Federal Register: March 30, 2004 (Volume 69, Number 61)]
[Notices]               
[Page 16530]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr30mr04-51]                         

-----------------------------------------------------------------------

DEPARTMENT OF DEFENSE

Office of the Secretary

 
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 April 
29, 2004.
    Title, Form, and OMB Number: Statement of Personal Injury--Possible 
Third Party Liability CHAMPUS; DD Form 2527; OMB Number 0720-0003.
    Type of Request: Reinstatement.
    Number of Respondents: 133,000.
    Responses Per Respondent: 1.
    Annual Responses: 133,000.
    Average Burden Per Response: 15 minutes.
    Annual Burden Hours: 33,250.
    Needs and Uses: This information collection is completed by CHAMPUS 
beneficiaries suffering from personal injuries and receiving medical 
care at Government expense. The information is necessary in the 
assertion of the Government's right to recovery under the Federal 
Medical Care Recovery Act. The data is used in the evaluation and 
processing of these claims.
    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 Health Affairs, Room 10236, 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/ESCD/Information Management 
Division, 1225 Jefferson Davis Highway, Suite 504, Arlington, VA 22202-
4326.

    Dated: March 24, 2004.
L.M. Bynum,
Alternate OSD Federal Register, Liaison Officer, Department of Defense.
[FR Doc. 04-7047 Filed 3-29-04; 8:45 am]

BILLING CODE 5001-06-M