OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive SVC Connect.

IC 237052 under ICR 202410-2900-019 · OMB 2900-0160.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive SVC Connect. 2900-0160
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 51 38 CFR 52

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-5588A Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive SVC Connect. VA Form 10-5588A.pdf http://www.va.gov/vaforms/ Yes No Fillable Printable

Health Health Care Services

 

45 0
   
State, Local, and Tribal Governments
 
   0 %

  Requested 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 540 0 0 0 0 540
Annual IC Time Burden (Hours) 180 0 0 0 0 180
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.