Information Collection

VA From 10-307: PCAFC Notice of Disagreement (NOD)

IC 249878 under ICR 202110-2900-006 · OMB 2900-0894.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0894 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-307 VA From 10-307: PCAFC Notice of Disagreement (NOD)	Form and Instruction
10-307 PCAFC Notice of Disagreement VA Form 10-307_Notice of Disagreement_PCAFC Decison Appeal_10212021.pdf	Form and Instruction
10-307 PCAFC Notice of Disagreement VA Form 10-307_Notice of Disagreement_PCAFC Decison Appeal_10212021.pdf	Form and Instruction

IC Title:

VA From 10-307: PCAFC Notice of Disagreement (NOD)

Agency IC Tracking Number:

2900-NEW

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 71

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
Form and Instruction	10-307	PCAFC Notice of Disagreement	VA Form 10-307_Notice of Disagreement_PCAFC Decison Appeal_10212021.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 85,540

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	85,540	85,540
Annual IC Time Burden (Hours)	42,770	42,770
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.