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Hip and Thigh Conditions Disability Benefits Questionnaire (21-0960M-8)
Hip and Thigh Conditions Disability Benefits Questionnaire (21-0960M-8)
OMB: 2900-0811
IC ID: 206585
OMB.report
VA
OMB 2900-0811
ICR 201612-2900-011
IC 206585
( )
Documents and Forms
Document Name
Document Type
Form 21-0960M-8
Hip and Thigh Conditions Disability Benefits Questionnaire (21-0960M-8)
Form
21-0960M-8 Hip and Thigh Conditions Disability Benefits Questionnai
21-0960M-8(12-19-16).pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Hip and Thigh Conditions Disability Benefits Questionnaire (21-0960M-8)
Agency IC Tracking Number:
2900-0811
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
38 CFR 3.326
38 CFR 3.351(d) and (e)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
21-0960M-8
Hip and Thigh Conditions Disability Benefits Questionnaire
21-0960M-8(12-19-16).pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Legislative Functions
Privacy Act System of Records
Title:
Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)
FR Citation:
75 FR 22187
Number of Respondents:
50,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
50,000
0
0
0
0
50,000
Annual IC Time Burden (Hours)
25,000
0
0
0
0
25,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.