View Information Collection (IC)
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View Information Collection (IC)
View Information Collection (IC)
IC Title:
Supportive Services for Veteran Families Program
Agency IC Tracking Number:
2900-0757
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
38 CFR Part 62 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
VA Form 10-10072
Supportive Services for Veterans Families Progrm Application
New Application 10-31-16b_VA Form 10-10072.pdf
Yes
No
Fillable Printable
Other-worksheet
Copy of NOFA_Budget_Template_10.26.16.xlsx
Yes
No
Fillable Fileable
Form
VA Form 10-10072a
SSVF Participant Satisfaction Survey
Participant Satisfaction Survey v11-4-16.docx
Yes
No
Fillable Printable
Form and Instruction
VA Form 10-10072b
Quarterly Grantee Performance Report
Quarterly Grantee Performance Report 10-10072b 11-4-16.doc
Yes
No
Fillable Printable
Other-Worksheet
Copy of Blank_SSVF FY16 Financial Report Template_UNLOCKED.xlsm
Yes
No
Fillable Printable
Form and Instruction
VA Form 10-10072c
Renewal Application for Supportive Services Grant
SSVF_2015_Renewal_Application_Form_Electronic 10-10072c v10-31-16b.pdf
http://vaww.va.gov/vaforms/medical/pdf/vha-10-10072C-fill.pdf
Yes
No
Fillable Printable
Other-Worksheet
Grantee certification template_11-4-16.docx
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,270
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
24,480
0
0
0
0
24,480
Annual IC Time Burden (Hours)
25,505
0
0
0
0
25,505
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.