PRESCRIPTION, AUTHORIZATION, APPLICATION, PROCUREMENT, REPAIR, AND LOAN OF PROSTHETIC ITEMS

ICR 199112-2900-004

OMB: 2900-0188

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0188 199112-2900-004
Historical Active 199009-2900-010
VA
PRESCRIPTION, AUTHORIZATION, APPLICATION, PROCUREMENT, REPAIR, AND LOAN OF PROSTHETIC ITEMS
Revision of a currently approved collection   No
Regular
Approved without change 02/14/1992
Retrieve Notice of Action (NOA) 12/06/1991
  Inventory as of this Action Requested Previously Approved
02/28/1995 02/28/1995 09/30/1993
512,844 0 512,844
51,284 0 51,284
0 0 0

WITH THESE FORMS AND FORM LETTERS, WE EFFECTIVELY MANAGE THE PROSTHETI PROGRAM. THEY ARE USED TO DETERMINE ELIGIBILITY, PRESCRIBE AND AUTHORIZE PROSTHETIC DEVICES, AS WELL AS TO OBTAIN ESTIMATES, ALLOW FOR DIRECT PURCHASE, AND OBTAIN INFORMATION ON LOANED ITEMS.

None
None


No

1
IC Title Form No. Form Name
PRESCRIPTION, AUTHORIZATION, APPLICATION, PROCUREMENT, REPAIR, AND LOAN OF PROSTHETIC ITEMS FL- 10-90, FL 10-426, 10-1394, 10-2421, 10-2520, 10-2914

  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 512,844 512,844 0 0 0 0
Annual Time Burden (Hours) 51,284 51,284 0 0 0 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.
12/06/1991


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