View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Authorization and Invoice for Medical and Hospital Services; Claim for Payment of Unauthorized Medical Services; Authority and Invoice for Travel by Ambulance or Other Hired Vehicle
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA10-7078 No No
Form 10-2511 No No
Form 10-583 No No


    

443,250 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 443,250 0 443,250 0 0 0
Annual IC Time Burden (Hours) 29,671 0 29,671 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.