2900-0091 - White Paper - Non-Substantive Change Request - VA Health Benefit Forms - 04182025

WHITE PAPER JUSTIFICATION

NON-SUBSTANTIVE CHANGE REQUEST

OMB Control Number 2900-0091

VA Health Benefits: Application, Update, Hardship Determination –

VA Forms 10-10EZ,10-10EZR, 10-10HS

Date Submitted: April 18, 2025

Summary of Request: VHA is submitting this non-substantive change request for updates to VA Forms 10-10EZ and 10-10EZR to align with Executive Order 14168: Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.

Description of Changes Requested: This request updates the sex/gender fields in VA Forms 10-10EZ and 10-10EZR, as described below, in accordance with EO 14168. There is no impact to the burden hours for this collection as a result of these changes.

Description of Changes:

Form	Type of Change	Question/Item	Requested Change
10-10EZ	Section I, Field 3A Revision	“Birth Sex: Male, Female”	Replace with: “Sex: Male, Female”
10-10EZ	Section I, Field 3B Deletion	“Self-Identified Gender Identity: Man, Woman, Transgender Man, Transgender Woman, Non-Binary, Prefer Not To Answer, A Gender Not Listed Here”	Delete entire Field
10-10EZ	Section IV, Field 1C Deletion	“Spouse’s Self-Identified Gender Identity: Man, Woman, Transgender Man, Transgender Woman, Non-Binary, Prefer Not To Answer, A Gender Not Listed Here”	Delete entire Field
10-10EZR	Section I, Field 3A Revision	“Birth Sex: Male, Female”	Replace with: “Sex: Male, Female”
10-10EZR	Section I, Field 3B Deletion	“Self-Identified Gender Identity: Man, Woman, Transgender Man, Transgender Woman, Non-Binary, Prefer Not To Answer, A Gender Not Listed Here”	Delete entire Field
10-10EZR	Section IV, Field 4 Deletion	“Spouse’s Self-Identified Gender Identity: Man, Woman, Transgender Man, Transgender Woman, Non-Binary, Prefer Not To Answer, A Gender Not Listed Here”	Delete entire Field