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Federal forms, ICRs, and supporting documents

Information Collection

Durable Power of Attorney for Health Care and Living Will, VA Advance Directive

IC 28738 under ICR 201704-2900-012 · OMB 2900-0556.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Durable Power of Attorney for Health Care and Living Will, VA Advance Directive 2900-0556
 
No Unchanged
 
Voluntary
 
38 CFR 17.32

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-0137 VA Advance Directive - Durable Power of Attorney for Health Care and Living Will va-10-0137_Nov_2016_fillable.pdf Yes No Fillable Printable
Form and Instruction 10-0137 VA Advance Directive - Durable Power of Attorney for Health Care and Living Will - Spanish_English va-10-0137-Spanish-English_Nov_2016_Fillable.pdf Yes No Fillable Printable

Health Health Care Services

 

343,622 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 343,622 0 0 0 0 343,622
Annual IC Time Burden (Hours) 171,811 0 0 0 0 171,811
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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