Information Collection

Veteran Reimbursement Claim Form

IC 262985 under ICR 202310-2900-005 · OMB 2900-0940.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-320 Veteran Reimbursement Claim Form	Form and Instruction
Form 10-320 Veteran Reimbursement Claim Form Veteran Reimbursement Claim Form	Form and Instruction
10-320 Veteran Reimbursement Claim Form VA Form 10-320_updated Sep 2023.pdf	Form and Instruction
10-320 Veteran Reimbursement Claim Form VA Form 10-320 2024-03-27.pdf	Form and Instruction

IC Title:

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:

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	10-320				Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 85,700

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	85,700	85,700
Annual IC Time Burden (Hours)	14,283	14,283
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.

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