OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR CONSIDERATION OF HOME IN THE COMMUNITY CARE PROGRAM

ICR 198204-2900-001 · OMB 2900-0081 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
146935 APPLICATION FOR CONSIDERATION OF HOME IN THE COMMUNITY CARE PROGRAM Form Migrated
ICR Details
2900-0081 198204-2900-001
Historical Inactive 198104-2900-019
VA
APPLICATION FOR CONSIDERATION OF HOME IN THE COMMUNITY CARE PROGRAM
Reinstatement without change of a previously approved collection   No
Regular
Withdrawn 06/02/1982
Retrieve Notice of Action (NOA) 04/02/1982
This request is withdrawn at request of agency.
  Inventory as of this Action Requested Previously Approved
10/31/1981
0 0 0
0 0 0
0 0 0
PROVIDES INFORMATION TO BE OBTAINED FROM AN APPLICANT WISHING TO PARTICIPATE AS A PROVIDER IN THE VA RESIDENTIAL CARE HOME PROGRAM. PERSONAL CARE HOME PROGRAM.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR CONSIDERATION OF HOME IN THE COMMUNITY CARE PROGRAM 10-2407
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/02/1982