Reimbursement of Adoption Expenses for Certain Veterans

Reimbursement of Qualifying Adoption Expenses for Certain Veterans, VA Form 10-10152

Documents and Forms

Document Name Document Type
Form 10-10152 Reimbursement of Adoption Expenses for Certain Veterans Form
10-10152 Reimbursement Request for Qualifying Adoption Expenses VA Form 10-10152.pdf Form
10-10152 Reimbursement Request for Qualifying Adoption Expenses VA Form 10-10152.pdf Form

Information Collection (IC) Details

IC Title:	Reimbursement of Adoption Expenses for Certain Veterans	Agency IC Tracking Number:	2900-0860

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-10152	Reimbursement Request for Qualifying Adoption Expenses	VA Form 10-10152.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Veterans and Beneficiaries Identification and Records Location Subsystem (38VA21)	FR Citation: 66 FR 30049

Number of Respondents: 80	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	80	80
Annual IC Time Burden (Hours)	480	480
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.