Information Collection

Application For Physicians, Dentists, Podiatrists And Optometrists

IC 147572 under ICR 198606-2900-007 · OMB 2900-0207.

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS AND OPTOMETRISTS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA 10-2850				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,900	12,900
Annual IC Time Burden (Hours)	6,450	6,450
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.