View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 2900-0648	ICR Reference No: 201207-2900-006
Status: Historical Active	Previous ICR Reference No: 200905-2900-004
Agency/Subagency: VA	Agency Tracking No: 2900-0648
Title: Foreign Medical Program Application and Claim Cover Sheet
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: 03/22/2013
	Date Received in OIRA: 11/06/2012
Terms of Clearance: VA is reminded to include the expiration date on any on-line/electronic versions of these forms.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved	03/31/2013
Responses	21,580	0	21,580
Time Burden (Hours)	3,762	0	3,762
Cost Burden (Dollars)	0	0	0

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