10-10143e Secondary Authorization Request (SAR) for VA Community Care

Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)

OMB: 2900-0823

IC ID: 221260

Information Collection (IC) Details

View Information Collection (IC)

10-10143e Secondary Authorization Request (SAR) for VA Community Care 2900-0823
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-10143e SAR for VA Community Care VA Form 10-10143e_Secondary Auth Request_ Community Care.pdf Yes Yes Fillable Printable

Health Health Care Services

 

366,823 0
   
Individuals or Households
 
   0 %

  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 1,834,115 0 0 0 0 1,834,115
Annual IC Time Burden (Hours) 611,372 0 0 0 0 611,372
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy