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Agenda
Reg Review
ICR
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