Exam for Housebound Status or Permanent Need for Regular Aid and Attendance

ICR 201309-2900-013

OMB: 2900-0721

Federal Form Document

IC Document Collections
ICR Details
2900-0721 201309-2900-013
Historical Inactive 201107-2900-023
VA 2900-0721 VBA-COMP-NK
Exam for Housebound Status or Permanent Need for Regular Aid and Attendance
Revision of a currently approved collection   No
Regular
Withdrawn and continue 12/13/2013
Retrieve Notice of Action (NOA) 09/19/2013
VA has requested withdrawal of this information collection request.
  Inventory as of this Action Requested Previously Approved
03/31/2015 36 Months From Approved 05/31/2015
14,000 0 14,000
7,000 0 7,000
0 0 0

This form will be used to gather medical information on behalf of beneficiaries or claimants who are requesting the aid and attendance or housebound benefit and who receive treatment from private doctors or physicians.

US Code: 38 USC 1541(d) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1541(e) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1521(d) Name of Law: Veterans of a period of war
   US Code: 38 USC 1521(e) Name of Law: Veterans of a period of war
   US Code: 38 USC 1114 Name of Law: Rates of wartime disability compensation
   US Code: 38 USC 1115(1)(e) Name of Law: Additional compensation for dependents
   US Code: 38 USC 1311(d) Name of Law: Dependency and indemnity compensation to a surviving spouse
  
None

2900-AO81 Proposed rulemaking 78 FR 211 10/31/2013

No

No
No

$642,600
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 [email protected]

  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.
09/19/2013


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