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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.