Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification Regarding Lobbying Modified 165 14 0 Form 10-0144
Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals Modified 165 14 0 Form 10-0143
Request for Prescription Drugs from an Eligible Veteran in a State Home Modified 1980 1980 0 Form 10-0460a
State Home Inspection Staffing Profile Modified 165 83 0 Form and Instruction 10-3567
Statement of Assurance of Compliance with Equal Opportunity Laws Modified 165 14 0 Form 10-0144A
Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973 Modified 165 14 0 Form 10-0143A
Total burden requested under this ICR: 2805 2119 0  
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