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Federal forms, ICRs, and supporting documents

Information Collection

Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire

IC 206553 under ICR 201709-2900-019 · OMB 2900-0801.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 21-0960M-3
Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire		 Form
21-0960M-3 Non-Degenerative Arthritis (including inflammatory, auto
VBA-21-0960M-3-ARE.pdf
www.va.gov/vaforms 		Form

Information Collection (IC) Details

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Information Collection Instruments:
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Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 21-0960M-3 Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire VBA-21-0960M-3-ARE.pdf www.va.gov/vaforms Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


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  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 100,000 0 0 0 0 100,000
Annual IC Time Burden (Hours) 25,000 0 0 0 0 25,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.