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: 2900-0160	ICR Reference No: 200608-2900-010
Status: Historical Active	Previous ICR Reference No: 200307-2900-003
Agency/Subagency: VA	Agency Tracking No:
Title: Title 38, Parts 51 and 52, State Home Programs
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/11/2006
	Date Received in OIRA: 08/29/2006
Terms of Clearance: Approved consistent with the following terms of clearance: in the next submission of this collection to OMB VA shall provide an update on the status of Dept. efforts to provide a fully electronic capability for the completion and submission of associated forms including recognition of electronic signatures.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2009	36 Months From Approved	10/31/2006
Responses	47,658	0	45,521
Time Burden (Hours)	15,535	0	15,127
Cost Burden (Dollars)	0	0	0

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

IC Title	Form No.	Form Name
Title 38, Parts 51 and 52, State Home Program	10-0144A, 10-10SH, 10-3567, 10-5588, 10-0143, 10-0143A, 10-0144	, , , , , ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	47,658	45,521	2,137
Annual Time Burden (Hours)	15,535	15,127	408
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: The adjustment of 408 burden hours is due to the increase of 11 Nursing Homes, six Domiciliaries and 2 Adult Day Health Care Centers utilizing this program.

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