Information Collection

Supplemental Physical Examination Report

IC 28541 under ICR 200804-2900-005 · OMB 2900-0324.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 29-8146 Supplemental Physical Examination Report	Form
VA Form 29-8146 Supplemental Physical Examination Report 29-8146.pdf	Form
VA Form 29-8160 Supplemental Physical Examination Report (Diabetes - Phy 29-8160.PDF	Form
VA Form 29-8158 Attending Physician's Statement 29-8158.pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0324

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 8.5

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 29-8146	Supplemental Physical Examination Report	29-8146.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 29-8160	Supplemental Physical Examination Report (Diabetes - Physician's Report)	29-8160.PDF	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 29-8158	Attending Physician's Statement	29-8158.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,440	1,440
Annual IC Time Burden (Hours)	1,080	1,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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