Information Collection

Notification of Veteran Change of Address

IC 242673 under ICR 202011-2900-008 · OMB 2900-0768.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0768 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Notification of Veteran Change of Address	Agency IC Tracking Number:	2900-0768

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 71

Information Collection 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: âPatient Medical Records --VAâ (24VA19), âEnrollment and Eligibility Records --VAâ (147VA16), and âHealth Administration Center Civilian Health and Medical Program Records--VAâ (54VA17)	FR Citation: 69 FR 18428

Number of Respondents: 3,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,250	3,250
Annual IC Time Burden (Hours)	542	542
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.