OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Application for Comprehensive Assistance for Family Caregivers Program

IC 197562 under ICR 202007-2900-002 · OMB 2900-0768.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Application for Comprehensive Assistance for Family Caregivers Program 2900-0768
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 71

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction VA Form 10-10CG Application for the Program of Comprehensive Assistance for Family Caregivers VA Form 10-10CG_revised 08062020.pdf http://www.va.gov/vaforms/medical/pdf/10-10CG.pdf Yes Yes Fillable Fileable

Health Health Care Services

“Patient Medical Records --VA” (24VA19), “Enrollment and Eligibility Records --VA” (147VA16), and “Health Administration Center Civilian Health and Medical Program Records--VA” (54VA17)  69 FR 18428

62,776 0
   
Individuals or Households
 
   75 %

  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 62,776 0 46,276 0 0 16,500
Annual IC Time Burden (Hours) 15,694 0 11,569 0 0 4,125
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.