VA Form 10-0137

VA Advance Directive - Durable Power of Attorney for Health Care and Living Will (VA Form 10-0137)

OMB: 2900-0556

IC ID: 242471

Information Collection (IC) Details

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VA Form 10-0137 2900-0556
 
No Modified
 
Voluntary
 
38 CFR 17.32

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-0137 VA Advance Directive - Durable Power of Attorney for Health Care and Living Will VA Form 10-0137_VA Advance Directive_updated Oct 2020.pdf Yes No Fillable Printable
Form and Instruction 10-0137 VA Advance Directive - Durable Power of Atttorney for Health Care and Living WIll (English-Spanish) VA Form 10-0137_VA Advance Directive_Spanish-English_updated Oct 2020.pdf Yes No Fillable Printable

Health Health Care Services

 

343,622 0
   
Individuals or Households
 
   0 %

  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 343,622 0 0 0 343,622 0
Annual IC Time Burden (Hours) 171,811 0 0 0 171,811 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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