Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4)

OMB 2900-0606

Third-party payers may be asked to provide evidence of payments completed so VA can determine if equivalent private sector provider payment is properly demonstrated.

The latest form for Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4) expires 2021-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
2900-0606 Justification Part A_082317 (1).docx Supporting Statement A
30 Day FRN_Published_111517.pdf Supplementary Document
60 Day FRN_Published_082817.pdf Supplementary Document
Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4) Other-Regulation

All Historical Document Collections

201708-2900-035 Approved without change	Reinstatement without change of a previously approved collection	2018-05-03
201403-2900-013 Approved without change	Revision of a currently approved collection	2014-08-19
201102-2900-006 Approved with change	Extension without change of a currently approved collection	2011-06-09
200712-2900-029 Approved without change	Extension without change of a currently approved collection	2008-04-03
200505-2900-005 Approved without change	Extension without change of a currently approved collection	2005-05-11
200203-2900-001 Approved without change	Extension without change of a currently approved collection	2002-03-05
199812-2900-006 Approved without change	New collection (Request for a new OMB Control Number)	1998-12-17