View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 2900-0080	ICR Reference No: 199408-2900-004
Status: Historical Active	Previous ICR Reference No: 199108-2900-003
Agency/Subagency: VA	Agency Tracking No:
Title: AUTHORIZATION AND INVOICE FOR MEDICAL AND HOSPITAL SERVICES, CLAIM FOR PAYMENT OF UNAUTHORIZED MEDICAL SERVICES, AUTHORITY & INVOICE FOR TRAVEL BY AMBULANCE OR...
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 08/17/1994
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/17/1994
	Date Received in OIRA: 08/17/1994
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1994	12/31/1994	09/30/1994
Responses	443,250	0	443,250
Time Burden (Hours)	29,500	0	29,500
Cost Burden (Dollars)	0	0	0

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