Counseling Record - Personal Information

ICR 200404-2900-004

OMB: 2900-0092

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
28255 Migrated
ICR Details
2900-0092 200404-2900-004
Historical Active 200103-2900-001
VA
Counseling Record - Personal Information
Extension without change of a currently approved collection   No
Regular
Approved without change 07/06/2004
Retrieve Notice of Action (NOA) 04/28/2004
  Inventory as of this Action Requested Previously Approved
07/31/2007 07/31/2007 07/31/2004
60,000 0 60,000
30,000 0 30,000
0 0 0

This form assists a VA counselor to quickly and effectively determine entitlement to services. It then serves as a guide to explore the client's counseling and program planning needs.

None
None


No

1
IC Title Form No. Form Name
Counseling Record - Personal Information 28-1902

  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 60,000 60,000 0 0 0 0
Annual Time Burden (Hours) 30,000 30,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
04/28/2004


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