Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application and Renewal for Health Benefits Modified 1017000 455750 0 Form and Instruction VA Form 10-10HS Request for Hardship Determination
Applications and Renewal for Health Benefits Unchanged 1017000 0 0 Form and Instruction 10-10EC Application for Extended Care Benefits
Form and Instruction 10-10d Application for CHAMPVA
Form and Instruction 10-10EZ Enrollment Application for Health Benefits
Form and Instruction 10-10EZR Health Benefits Update Form
Total burden requested under this ICR: 2034000 455750 0  
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