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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
APPLICATION FOR ADAPTIVE EQUIPMENT MOTOR VEHICLE
New
4000
1000
0
Form
10-1394
APPLICATION FOR ADAPTIVE EQUIPMENT MOTOR VEHICLE
Claim, Authorization & Invoice for Prosthetic Items & Services
Removed
0
0
0
Form
10-0103
VETERANS APPLICATION FOR ASSISTANCE In Acquiring Home Improvement and Structural Alterations
Form
10-1394
APPLICATION FOR ADAPTIVE EQUIPMENT MOTOR VEHICLE
Form and Instruction
10-2421
PROSTHETIC AUTHORIZATION FOR ITEMS OR SERVICES
Form
FL 10-90
Request to submit Quotation
Form
VA Form 10-2914
Prescription and Authorization for Glasses
Form
VA Form 10-2520
Prosthetic Service Card Invoice
PRESCRIPTION AND AUTHORIZATION FOR FEE BASIS EYEGLASSES
New
50000
3333
0
Form
10-2914
PRESCRIPTION AND AUTHORIZATION FOR FEE BASIS EYEGLASSES
PROSTHETIC AUTHORIZATION FOR ITEMS OR SERVICES
New
1000
67
0
Form
10-2421
PROSTHETIC AUTHORIZATION FOR ITEMS OR SERVICES
PROSTHETIC SERVICE CARD INVOICE
New
700
47
0
Form
10-2520
PROSTHETIC SERVICE CARD INVOICE
REQUEST TO SUBMIT QUOTATION
New
8500
708
0
Form
FL 10-90
REQUEST TO SUBMIT QUOTATION
VETERANS APPLICATION FOR ASSISTANCE In Acquiring Home Improvements and Structural Alterations
New
7000
583
0
Form
10-0103
VETERANS APPLICATION FOR ASSISTANCE In Acquiring Home Improvements and Structural Alterations
Total burden requested under this ICR:
71200
5738
0
To view an IC, click on IC Title