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VCAP Appointment Certification Form
Veterans Child Care Assistance Program (VCAP)
OMB:
IC ID: 269562
OMB.report
VA
ICR 202407-2900-010
IC 269562
( )
Documents and Forms
Document Name
Document Type
Form 10-381
VCAP Appointment Certification Form
Form
10-381 Appointment Certification Form
VA Form 10-381_Sep 2024.pdf
Form
10-381 Appointment Certification Form
VA Form 10-381_Sep 2024.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
VCAP Appointment Certification Form
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
10-381
Appointment Certification Form
VA Form 10-381_Sep 2024.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
24VA19 "Patient Medical Record--VA"
FR Citation:
69 FR 18428
Number of Respondents:
290,528
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
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
3,776,864
0
3,776,864
0
0
0
Annual IC Time Burden (Hours)
125,895
0
125,895
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.
