Information Collection

Reimbursement of Adoption Expenses for Certain Veterans

IC 226992 under ICR 201705-2900-010 · OMB 2900-0860.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0860 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-10152 Reimbursement of Adoption Expenses for Certain Veterans	Form
10-10152 Reimbursement Request for Qualifying Adoption Expenses 10-10152 - Final - 080618.pdf	Form

IC Title:

Reimbursement of Adoption Expenses for Certain Veterans

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-10152	Reimbursement Request for Qualifying Adoption Expenses	10-10152 - Final - 080618.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Veterans and Beneficiaries Identification and Records Location Subsystem (38VA21)

FR Citation: 66 FR 30049

Number of Respondents: 80

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.