Application for Comprehensive Assistance for Family Caregivers Program

Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Form 10-10CG

OMB: 2900-0768

IC ID: 197562

Information Collection (IC) Details

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Application for Comprehensive Assistance for Family Caregivers Program 2900-0768
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 71

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction VA Form 10-10CG Application for the Program of Comprehensive Assistance for Family Caregivers VA Form 10-10CG.pdf http://www.va.gov/vaforms/medical/pdf/10-10CG.pdf Yes Yes Fillable Fileable

Health Health Care Services

“Patient Medical Records --VA” (24VA19), “Enrollment and Eligibility Records --VA” (147VA16), and “Health Administration Center Civilian Health and Medical Program Records--VA” (54VA17)  69 FR 18428

110,671 0
   
Individuals or Households
 
   75 %

  Approved 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 110,671 0 47,895 0 0 62,776
Annual IC Time Burden (Hours) 27,668 0 11,974 0 0 15,694
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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