OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Application Requirements to Receive VA Dental Insurance Plan Benefits under 38 CFR 17.169

IC 202798 under ICR 201611-2900-004 · OMB 2900-0789.

Documents and Forms
Document Name
Document Type
Other-Fact Sheet
Information Collection (IC) Details

View Information Collection (IC)

Application Requirements to Receive VA Dental Insurance Plan Benefits under 38 CFR 17.169
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 17.169

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Fact Sheet VADIP_Fact_Sheet_v14.pdf Yes No Printable Only

Health Health Care Services

 

283,500 0
   
Individuals or Households
 
   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 283,500 0 0 0 0 283,500
Annual IC Time Burden (Hours) 38,350 0 0 0 0 38,350
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.