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: 2900-0101	ICR Reference No: 200505-2900-003
Status: Historical Active	Previous ICR Reference No: 200203-2900-007
Agency/Subagency: VA	Agency Tracking No:
Title: Eligibility Verification Reports
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/2005
	Date Received in OIRA: 05/02/2005
Terms of Clearance: Approved cosistent with the following terms of clearance: in the next submission of this collection of information to OMB VA shall provide a report on the status of integrating forms approved under this package into a fully electronic format which respondents may complete and submit online.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2008	07/31/2008	07/31/2005
Responses	219,000	0	293,894
Time Burden (Hours)	113,075	0	146,947
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Eligibility Verification Reports	21-0510, 21-0512S-1, 21-0512V-1, 21-0513-1, 21-0514, 21-0514-1, 21-0516, 21-0516-1, 21-0518, 21-0518-1

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	219,000	293,894	-74,894
Annual Time Burden (Hours)	113,075	146,947	-33,872
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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