Information Collection

Agreement to Train On The Job Disabled Veterans

IC 28956 under ICR 200901-2900-003 · OMB 2900-0678.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0678 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 28-1904 Agreement to Train On The Job Disabled Veterans	Form
28-1904 Agreement to Train On The Job Disabled Veterans 28-1904(10-05).pdf	Form

IC Title:

Agreement to Train On The Job Disabled Veterans

Agency IC Tracking Number:

2900-0678

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.212

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	28-1904	Agreement to Train On The Job Disabled Veterans	28-1904(10-05).pdf		No		Printable Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.