Information Collection

10-10143c Submission of Information on Credentials and Licenses by Eligible Entities and Providers

IC 213638 under ICR 202008-2900-001 · OMB 2900-0823.

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IC Title:

10-10143c Submission of Information on Credentials and Licenses by Eligible Entities and Providers

Agency IC Tracking Number:

2900-0823

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 1730(d) (To search for a specific CFR, visit the Code of Federal Regulations.)

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 122,274

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	122,274	122,274
Annual IC Time Burden (Hours)	10,190	10,190
Annual IC Cost Burden (Dollars)	0	0

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