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View ICR - OIRA Conclusion

OMB Control No: 2900-0219	ICR Reference No: 201602-2900-032
Status: Historical Active	Previous ICR Reference No: 201211-2900-001
Agency/Subagency: VA	Agency Tracking No: 2900-0219
Title: CHAMP VA Benefits - Application, Claim, Other Health Insurance & Potential Liability
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 with change	Conclusion Date: 09/12/2016
	Date Received in OIRA: 03/01/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	09/30/2016	09/30/2016
Responses	339,619	0	339,619
Time Burden (Hours)	56,570	0	56,570
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 42 USC Section 2652 Name of Law: Regulations
   US Code: 42 USC Section 2653 Name of Law: Limitation or repeal of other provisions for recovery of hospital and medical care costs
   EO: EO 9397 Name/Subject of EO: Number System for Federal Accounts Relating to Individual Persons
   US Code: 38 USC Section 501 Name of Law: Rules and regulations
   US Code: 38 USC Section 1781 Name of Law: Medical care for survivors and dependents of certain veterans
   US Code: 42 USC Section 2651 Name of Law: Recovery by United States
   US Code: 10 USC Section 1079 Name of Law: Contracts for medical care for spouses and children: plans
   US Code: 10 USC Section 1086 Name of Law: Contracts for health benefits for certain members, former members, and their dependents

Citations for New Statutory Requirements: None

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	339,619	339,619	-339,643	339,643
Annual Time Burden (Hours)	56,570	56,570	-56,576	56,576
Annual Cost Burden (Dollars)	0	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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