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Regulation on Application for Fisher Houses and Other Temporary Lodging
Regulation on Application for Fisher Houses and Other Temporary Lodging
OMB: 2900-0630
IC ID: 28902
OMB.report
VA
OMB 2900-0630
ICR 201706-2900-005
IC 28902
( )
Documents and Forms
Document Name
Document Type
Form 10-0408A
Regulation on Application for Fisher Houses and Other Temporary Lodging
Form and Instruction
10-0408A Temporary Housing Application
10-0408A.pdf
vaww.va.gov/vaforms/medical/pdf/vha-10-0408A-fill.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Regulation on Application for Fisher Houses and Other Temporary Lodging
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
10-0408A
Temporary Housing Application
10-0408A.pdf
http://vaww.va.gov/vaforms/medical/pdf/vha-10-0408A-fill.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
250,000
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
500,000
0
-500,000
500,000
0
500,000
Annual IC Time Burden (Hours)
83,333
0
-83,333
83,333
0
83,333
Annual IC Cost Burden (Dollars)
0
0
-1,999,992
1,999,992
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.