Information Collection

Supplemental Physical Examination Report

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

Documents and Forms

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 www.va.gov/vaforms Form
VA Form 29-8160 Supplemental Physical Examination Report (Diabetes - Phy 29-8160.PDF www.va.gov/vaforms Form
VA Form 29-8158 Attending Physician's Statement 29-8158.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Physical Examination Report	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:

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 %

	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

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.