Title 38, Parts 51 and 52, State Home Program

Title 38, Parts 51 and 52, State Home Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0160 can be found here:

Documents and Forms

Document Name Document Type
Form 10-0143 Title 38, Parts 51 and 52, State Home Program Form
10-0143 Department of Veterans Affairs Certification Regarding D 2900-0160 VA Form 10-0143.pdf www.va.gov/vaforms/ Form

Information Collection (IC) Details

IC Title:	Title 38, Parts 51 and 52, State Home Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 51 38 CFR 52

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-0143	Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals	2900-0160 VA Form 10-0143.pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,884	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	12,884	12,884
Annual IC Time Burden (Hours)	6,818	6,818
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.