Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application and Renewal for Health Benefits Removed 0 0 0 Form and Instruction VA Form 10-10HS Request for Hardship Determination
Applications and Renewal for Health Benefits Removed 0 0 0 Form and Instruction 10-10EZ Enrollment Application for Health Benefits
Form and Instruction 10-10EZR Health Benefits Update Form
Form and Instruction 10-10EZ - Spanish Version INSTRUCCIONES PARA SOLICITAR LA AFILIACIÓN A LOS BENEFICIOS MÉDICOS
VA Form 10-10EZ -- Application for Health Benefits New 500000 250000 0 Form and Instruction 10-10EZ Application for Health Benefits
VA Form 10-10EZR -- Health Benefits Update Form New 510000 204000 0 Form and Instruction 10-10EZR Health Benefits Update Form
Total burden requested under this ICR: 1010000 454000 0  
To view an IC, click on IC Title