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: 2900-0768	ICR Reference No: 201105-2900-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: Joint Application for Comprehensive Assistance and Support Services for Family Caregivers, VA Form 10-10CG
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 05/03/2011
OIRA Conclusion Action: Preapproved	Conclusion Date: 05/03/2011
	Date Received in OIRA: 05/03/2011
Terms of Clearance: VA is developing an online application. When then the online application is ready, VA will upload screen shots along with a request for a non-substantive change.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2011	6 Months From Approved
Responses	5,000	0	0
Time Burden (Hours)	1,250	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Request	Change Due to New Statute
Annual Number of Responses	5,000	5,000
Annual Time Burden (Hours)	1,250	1,250
Annual Cost Burden (Dollars)	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: This is a new collection. All burden hours are considered an increase.

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