Prescription, Authorization, Application, Procurement, Repair, and Loan of Prosthetic Items

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0188 can be found here:

Documents and Forms

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no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

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IC Title:	Prescription, Authorization, Application, Procurement, Repair, and Loan of Prosthetic Items	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	VA-10-2421	No	No
Form	FL-10-90	No	No
Form	VA-10-2914	No	No
Form	VA-10-0103	No	No
Form	VA-10-1394	No	No
Form	FL-10-426	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 519,844	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	519,844	7,000	512,844
Annual IC Time Burden (Hours)	37,079	583	36,496
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.