Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive SVC Connect. Modified 540 180 0 Form and Instruction 10-5588A
State Home Report and Statement of Federal Aid Claimed Modified 1668 834 0 Form 10-5588
State Homes Program Application for Veterans Care Medical Certification Modified 11406 3802 0 Form and Instruction 10-10SH
Form and Instruction 10-10SH
Total burden requested under this ICR: 13614 4816 0  
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