Information Collection

Eligiblity Verification Reports (evr)

IC 147053 under ICR 199207-2900-011 · OMB 2900-0101.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0101 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	ELIGIBLITY VERIFICATION REPORTS (EVR)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	VA 21-0510	No	No
Form	21-0511S-1	No	No
Form	21-0511V	No	No
Form	21-0511V-1	No	No
Form	21-0512S	No	No
Form	21-0512S-1	No	No
Form	21-0513	No	No
Form	21-0513-1	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,022,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,533,600	422,170	1,111,430
Annual IC Time Burden (Hours)	766,800	211,085	555,715
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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