Fiduciary Agreement (VA Form 21P-4703)

OMB 2900-0319

VA Form 21P-4703 is used as an agreement between the Department of Veterans Affairs and a federally-appointed fiduciary for a beneficiary's VA benefits. It outlines the fiduciary's responsibilities with respect to the use of funds derived from VA benefits.

The latest form for Fiduciary Agreement (VA Form 21P-4703) expires 2020-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 21P-4703 Fiduciary Agreement (VA Form 21P-4703) Form
30-Day FRN - 2900-0319 (2024).pdf Supplementary Document
2900-0319 Supporting Statement (21P-4703).docx Supporting Statement A
60-Day FRN (published).pdf Supplementary Document
Fiduciary Agreement (VA Form 21P-4703) Form

All Historical Document Collections

202401-2900-007	Revision of a currently approved collection	2024-04-15
202012-2900-002 Approved without change	Reinstatement without change of a previously approved collection	2021-05-05
201607-2900-006 Approved without change	Revision of a currently approved collection	2017-08-16
201506-2900-007 Approved without change	Revision of a currently approved collection	2015-11-13
201308-2900-028 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-09-19
201205-2900-005 Approved without change	Extension without change of a currently approved collection	2012-11-01
200906-2900-010 Approved without change	Extension without change of a currently approved collection	2009-09-11
200608-2900-012 Approved without change	Revision of a currently approved collection	2006-08-29
200309-2900-001 Approved with change	Revision of a currently approved collection	2003-09-11
200307-2900-002 Withdrawn and continue	Revision of a currently approved collection	2003-07-10
200008-2900-011 Approved without change	Reinstatement without change of a previously approved collection	2000-08-18
199909-2900-015 Withdrawn	Reinstatement without change of a previously approved collection	1999-09-13
199506-2900-010 Approved without change	Extension without change of a currently approved collection	1995-06-26
199202-2900-015 Approved without change	Reinstatement with change of a previously approved collection	1992-02-24
198810-2900-002 Approved without change	Revision of a currently approved collection	1988-10-28
198601-2900-010 Approved with change	No material or nonsubstantive change to a currently approved collection	1986-01-08
198511-2900-002 Approved without change	Revision of a currently approved collection	1985-11-25
198308-2900-004 Approved without change	Reinstatement with change of a previously approved collection	1983-08-03
198209-2900-042 Approved with change	No material or nonsubstantive change to a currently approved collection	1982-09-08
198106-2900-010 Approved without change	New collection (Request for a new OMB Control Number)	1981-06-17