Information Collection

Title 38, Parts 51 and 52, State Home Program

IC 28394 under ICR 201906-2900-007 · OMB 2900-0160.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0160 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-0143 Title 38, Parts 51 and 52, State Home Program	Form
10-0143 Department of Veterans Affairs Certification Regarding D 2900-0160 VA Form 10-0143.pdf www.va.gov/vaforms/	Form

IC Title:

Title 38, Parts 51 and 52, State Home Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 51 38 CFR 52

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	10-0143	Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals	2900-0160 VA Form 10-0143.pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,884

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-12,884	12,884
Annual IC Time Burden (Hours)	-6,818	6,818
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.