38Pensions, Bonuses, and Veterans' Relief22004-07-012004-07-01falseFORMS58PART 58Pensions, Bonuses, and Veterans' ReliefDEPARTMENT OF VETERANS AFFAIRS (CONTINUED)Pt. 58PART 58—FORMSSec.58.10VA Form 10-3567—State Home Inspection: Staffing Profile.58.11VA Form 10-5588—State Home Report and Statement of Federal Aid Claimed.58.12VA Form 10-10EZ—Application for Health Benefits.58.13VA Form 10-10SH—State Home Program Application for Veteran Care—Medical Certification.58.14VA Form 10-0143A—Statement of Assurance of Compliance with Section 504 of The Rehabilitation Act of 1973.58.15VA Form 10-0143—Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals.58.16VA Form 10-0144—Certification Regarding Lobbying.58.17VA Form 10-0144A—Statement of Assurance of Compliance with Equal Opportunity Laws.Authority:
38 U.S.C. 101, 501, 1710, 1741-1743.
§ 58.10VA Form 10-3567—State Home Inspection Staffing Profile.ER06JA00.000ER06JA00.001ER06JA00.002§ 58.11VA Form 10-5588—State Home Report and Statement of Federal Aid Claimed.ER06JA00.003ER06JA00.004§ 58.12VA Form 10-10EZ—Application for Health BenefitsER06JA00.005ER06JA00.006§ 58.13VA Form 10-10SH—State Home Program Application for Veteran Care Medical Certification.ER06JA00.007ER06JA00.008ER06JA00.009§ 58.14VA Form 10-0143A—Statement of Assurance of Compliance with Section 504 of The Rehabilitation Act of 1973.ER06JA00.010§ 58.15VA Form 10-0143—Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals.ER06JA00.011ER06JA00.012§ 58.16VA Form 10-0144—Certification Regarding Lobbying.ER06JA00.013§ 58.17VA Form 10-0144A—Statement of Assurance of Compliance with Equal Opportunity Laws.ER06JA00.014