Veterans Health Administration White Paper
ICR 2900-0091 Non-Substantive Change
June 2014
Background
In compliance with the Paperwork Reduction Act of 1995, the Veterans Health Administration (VHA) submitted information collection request 2900-0091, Application and Renewal of Health Benefits, for OMB consideration. Submission package 2900-0091 includes forms that will be utilized in enrolling and updating the information of eligible Veterans seeking care within the Department of Veterans Affairs (VA) Healthcare System. Per recent review, and guidance received, VHA seeks to amend the declaration segment of VA forms 10-10D, 10-10EC, 10-10EZR, 10-10EZ through a non-substantive change.
Modification
The declaration statements made in the aforementioned forms have been modified to read as follows: “l declare under penalty of perjury that the foregoing is true and accurate to the best of my knowledge. I understand that any materially false, fictitious, or fraudulent statement or representation, made knowingly, is punishable by a fine and/or imprisonment pursuant to title 18, United States Code, Sections 287 and 1001.”
The language has been added or altered to align with current VA policies and federal law. This will ensure that Veterans who complete the aforementioned forms, under full faith and belief that their qualifications meet the outlined criteria, will not be subject to prosecution under 18 U.S.C. § 287 and 1001.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Manuel, Howard L. |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |