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Environmental Hazards Registry (EHR) Worksheet for Veterans

IC 236782 under ICR 201907-2900-001 · OMB 2900-0893.

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Environmental Hazards Registry (EHR) Worksheet for Veterans 2900-NEW
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-10176 Environmental Hazards Registry (EHR) Worksheet for Veterans VA Form 10-10176_revised 2020.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

20,000 0
   
Individuals or Households
 
   50 %

  Requested 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 20,000 0 20,000 0 0 0
Annual IC Time Burden (Hours) 20,000 0 20,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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