Information Collection

Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative

IC 28538 under ICR 201202-2900-004 · OMB 2900-0321.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0321 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative	Form
Form 21-22A Appointment of Individual as Claimant's Representative Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative	Form
21-22 Appointment of Veterans Service Organization as Claimant 21-22.pdf www.va.gov/vaforms/	Form
21-22A Appointment of Individual as Claimant's Representative 21-22a(6-09).pdf www.va.gov/vaforms/	Form

IC Title:

Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative

Agency IC Tracking Number:

2900-0321

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 1.525 38 CFR 14.631

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	21-22			http://www.va.gov/vaforms/	Yes	No	Fillable Printable
Form	21-22A			http://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: 331,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	331,400	331,400
Annual IC Time Burden (Hours)	27,616	27,616
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.

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