Information Collection

Regulation on Application for Fisher Houses and Other Temporary Lodging

IC 28902 under ICR 201110-2900-005 · OMB 2900-0630.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0630 can be found here:

Documents and Forms

Document Name Document Type
Form VA form 10-0408 Regulation on Application for Fisher Houses and Other Temporary Lodging Form
VA Form 10-0408A VHA Fisher House or Other Temporary Lodging Application 10-0408A.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-0408a-fill.pdf Form
VA form 10-0408 VHA Fisher House Application 10-0408-fill.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-0408-fill.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Regulation on Application for Fisher Houses and Other Temporary Lodging	Agency IC Tracking Number:	2900-0630

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	VA form 10-0408	VHA Fisher House Application	10-0408-fill.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-0408-fill.pdf	Yes	No	Fillable Printable
Form	VA Form 10-0408A	VHA Fisher House or Other Temporary Lodging Application	10-0408A.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-0408a-fill.pdf	Yes	No	Fillable Printable

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	Previously Approved
Annual Number of Responses for this IC	500,000	500,000
Annual IC Time Burden (Hours)	83,333	83,333
Annual IC Cost Burden (Dollars)	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.