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. Unchanged 540 180 0 Form and Instruction 10-5588A
List of Veteran Names for Reconsideration Unchanged 2 3 0
State Home Report and Statement of Federal Aid Claimed Unchanged 1668 834 0 Form 10-5588
State Homes Program Application for Veterans Care Medical Certification Unchanged 11406 3802 0 Form and Instruction 10-10SH
Form and Instruction 10-10SH
Total burden requested under this ICR: 13616 4819 0  
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