Information Collection

No Wrong Door System Management Tool-Veteran Directed

IC 234842 under ICR 201902-0985-002 · OMB 0985-0062.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0062 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
No Wrong Door System Management Tool-Veteran Directed	Form and Instruction
No Wrong Door Veteran Directed Care Tool NWD Veteran Directed Care Tool.docx	Form and Instruction

IC Title:

No Wrong Door System Management Tool-Veteran Directed

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	NA	No Wrong Door Veteran Directed Care Tool	NWD Veteran Directed Care Tool.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,800	4,800
Annual IC Time Burden (Hours)	2,400	2,400
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.