View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Advanced Directive - Living Will and Durable Power of Attorney	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 10-0137	VA Advance Directive: Durable Power of Attorney for Health Care and Living Will	2900-0556 Revised VAF 10-0137.pdf		No		Paper Only
Form	VA Form 10-0137	VA Advance Directive: Durable Power of Attorney for Health Care and Living Will	2900-0556 Old VAF 10-0137 with changes annotated.pdf		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 256,253	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	256,253	0	0	0	0	256,253
Annual IC Time Burden (Hours)	128,127	0	0	0	0	128,127
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.