APPLICATION FOR VOLUNTARY SERVICE

ICR 198510-2900-005

OMB: 2900-0090

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
174236 Migrated
ICR Details
2900-0090 198510-2900-005
Historical Active 198405-2900-006
VA
APPLICATION FOR VOLUNTARY SERVICE
No material or nonsubstantive change to a currently approved collection   No
Emergency 10/01/1985
Approved with change 10/01/1985
Retrieve Notice of Action (NOA) 10/01/1985
  Inventory as of this Action Requested Previously Approved
05/31/1987 05/31/1987 05/31/1987
36,000 0 30,000
9,000 0 7,500
0 0 0

THE FORM IS USED TO ASSIST PERSONNEL OF BOTH VOLUNTARY ORGANIZATIONS AND THE VETERANS ADMINISTRATIVE (VA) IN THE SELECTION, SCREENING AND PLACEMENT OF VOLUNTEERS IN THE VA'S CARE AND TREATMENT PROGRAM FOR VETERAN PATIENTS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR VOLUNTARY SERVICE VA10-7055

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 36,000 30,000 0 6,000 0 0
Annual Time Burden (Hours) 9,000 7,500 0 1,500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/01/1985


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