Funeral Arrangements Request Form

Funeral Arrangements

OMB: 2900-0080

IC ID: 210686

Information Collection (IC) Details

View Information Collection (IC)

Funeral Arrangements Request Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-2065 FUNERAL ARRANGEMENTS VA Form 10-2065 (Funeral Arrangements)_new statement.pdf Yes No Fillable Printable

Health Health Care Services

 

22,213 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 22,213 0 0 0 0 22,213
Annual IC Time Burden (Hours) 3,702 0 0 0 0 3,702
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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