OMB control number
Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4)
OMB 2900-0606 · VA.
OMB 2900-0606
Third-party payers may be asked to provide evidence of payments completed so VA can determine if equivalent private sector provider payment is properly demonstrated.
The latest form for Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4) expires 2021-06-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
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Supporting Statement A |
Supplementary Document |
Supplementary Document |
2900-0606 Justification Part A_082317 (1).docx
30 Day FRN_Published_111517.pdf
Regulation for Submission of Evidence - Title 38 CFR 17.101(a)(4) All Historical Document Collections
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Approved without change |
Reinstatement without change of a previously approved collection | 2018-05-03 | |
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Approved without change |
Revision of a currently approved collection | 2014-08-19 | |
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Approved with change |
Extension without change of a currently approved collection | 2011-06-09 | |
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Approved without change |
Extension without change of a currently approved collection | 2008-04-03 | |
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Approved without change |
Extension without change of a currently approved collection | 2005-05-11 | |
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Approved without change |
Extension without change of a currently approved collection | 2002-03-05 | |
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Approved without change |
New collection (Request for a new OMB Control Number) | 1998-12-17 |