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Federal forms, ICRs, and supporting documents

Information Collection

CHAMPVA Application for Benefits

IC 246417 under ICR 202407-2900-007 · OMB 2900-0219.

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Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

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CHAMPVA Application for Benefits 2900-0219
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 1.900 38 CFR 17.900 through 17.905

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-10d CHAMPVA Application for Benefits VA_Form_10-10d_updated 2024.pdf http://www.gov/vaforms/Search_action.asp Yes No Fillable Printable

Health Health Care Services

 

53,775 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 53,775 0 0 0 0 53,775
Annual IC Time Burden (Hours) 8,963 0 0 0 0 8,963
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.