Information Collection

Monthly Statement of Wages Paid to Trainee

IC 28574 under ICR 201108-2900-003 · OMB 2900-0368.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0368 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 28-1917 Monthly Statement of Wages Paid to Trainee	Form
VA Form 28-1917 Monthly Statement of Wages Paid to Trainee 28-1917.pdf www.va.gov/vaforms	Form

IC Title:

Monthly Statement of Wages Paid to Trainee

Agency IC Tracking Number:

2900-0368

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.296

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 28-1917	Monthly Statement of Wages Paid to Trainee	28-1917.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

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	3,600	3,600
Annual IC Time Burden (Hours)	1,800	1,800
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.