Memo Request to Discontinue VA Form

	Department of Veterans Affairs		Memorandum
Date:		October 18, 2013
From:		PRA Compliance Liaison, Veterans Health Administration (10B4)
Subject:		Request to Discontinue VA Forms: 10-2511. 10-583, and 10-7078
To:		VA Desk Officer, Office of Management & Budget (OMB)
Cc:		VA Clearance Officer, Crystal Rennie (OI&T- 005R1B)

The burden hour decrease is as a result agency discretion:

1. VA Form 10-2511: Applicant signature is not collected on VA Form 10-2511 when processing payment for ambulance or other hired vehicle for transportation of beneficiaries. For internal use only. No respondent burden hours apply.

2. VA Form 10-583: The form is no longer utilized. Health care billing forms CMS 1500/1450 have replaced form VA Form 10-583. No respondent burden hours apply.

3. VA Form 10-7078: This form is for internal VA medical center staff use, only. No respondent burden hours apply.