Information Collection

Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

IC 28273 under ICR 201001-2900-010 · OMB 2900-0099.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0099 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 22-5495 Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Form
VA Form 22-5495 Dependents' Request for Change of Program or Place of Tr 22-5495(1-10).pdf www.va.gov/vaforms	Form

IC Title:

Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

Agency IC Tracking Number:

2900-0099

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.4234

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	VA Form 22-5495	Dependents' Request for Change of Program or Place of Training	22-5495(1-10).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 38,418

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	38,418	38,418
Annual IC Time Burden (Hours)	12,646	12,646
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.