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: 201009-2900-007
Status: Historical Active	Previous ICR Reference No: 200706-2900-020
Agency/Subagency: VA	Agency Tracking No: 2900-0080
Title: Claim, Authorization and Invoice for Beneficiary Travel and other Miscellaneous Medical Services
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: 05/20/2011
	Date Received in OIRA: 02/08/2011
Terms of Clearance: Approved consistent with the following terms of clearance: OMB encourages VA to continue Departmental efforts aimed at providing respondents with a fully electronic version of associated forms that may be completed and submitted electronically and that include the recognition of electronic signatures.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	36 Months From Approved	05/31/2011
Responses	464,155	0	440,380
Time Burden (Hours)	33,079	0	30,391
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	464,155	440,380	23,775
Annual Time Burden (Hours)	33,079	30,391	2,688
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 burden increase is due to an increase in the estimated number of respondents.

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