Information Collection

Applications & Appraisals for Employment for Title 38 Positions and Trainees

IC 28443 under ICR 201203-2900-002 · OMB 2900-0205.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0205 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 10-2850 APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS, OPTOMETRISTS AND CHIROPRACTORS Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA Form 10-2850C APPLICATION FOR ASSOCIATED HEALTH OCCUPATIONS Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA Form 10-2850d Application for Health Professions Trainees Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA FL 10-341(a) Employment Reference for Title 38 Employee Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA FL 10-341(b) Trainee Qualification and Credentials Verification Letter (TQCVL) Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA Form 10-2850a APPLICATION FOR NURSES AND NURSE ANESTHETISTS Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
Form VA form 10-2850b Application for Residents Applications & Appraisals for Employment for Title 38 Positions and Trainees	Form and Instruction
VA Form 10-2850 APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS, OPTOM 10-2850 rev.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850-fill.pdf	Form and Instruction
VA Form 10-2850C APPLICATION FOR ASSOCIATED HEALTH OCCUPATIONS 10-2850c rev.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf	Form and Instruction
VA Form 10-2850d Application for Health Professions Trainees 10-2850d Fill (2).pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850d-fill.pdf	Form and Instruction
VA FL 10-341(a) Employment Reference for Title 38 Employee VA FL-10-341a.pdf vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341a-fill.pdf	Form and Instruction
VA FL 10-341(b) Trainee Qualification and Credentials Verification Lette VA FL 10-341b.pdf vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341b-fill.pdf	Form and Instruction
VA Form 10-2850a APPLICATION FOR NURSES AND NURSE ANESTHETISTS 10-2850a rev.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf	Form and Instruction
VA form 10-2850b Application for Residents 10-2850b rev.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850b-fill.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Applications & Appraisals for Employment for Title 38 Positions and Trainees

Agency IC Tracking Number:

2900-0205

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VA Form 10-2850	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850C	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850d	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850d-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA FL 10-341(a)	http://vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341a-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA FL 10-341(b)	http://vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341b-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850a	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA form 10-2850b	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850b-fill.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 412,787

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	412,787	85,739	327,048
Annual IC Time Burden (Hours)	153,833	23,861	129,972
Annual IC Cost Burden (Dollars)	0	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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