Statement of Assurance of Compliance with Equal Opportunity Laws

Per Diem to States for Care of Eligible Veterans in State Homes

OMB: 2900-0883

IC ID: 242719

Documents and Forms

Document Name Document Type
Form 10-0144A Statement of Assurance of Compliance with Equal Opportunity Laws Form
10-0144A Statement of Assurance of Compliance with Equal Opportunity Laws VA Form 10-0144A.pdf www.va.gov/vaforms/ Form