Information Collection

Agreement to Train On The Job Disabled Veterans (28-1904)

IC 28956 under ICR 201403-2900-022 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 28-1904 Agreement to Train On The Job Disabled Veterans (28-1904) Form
28-1904 AGREEMENT TO TRAIN ON THE JOB DISABLED VETERANS (Chapter VA Form 28-1904 (8-28-14).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Agreement to Train On The Job Disabled Veterans (28-1904)	Agency IC Tracking Number:	2900-0678 VBA-VR&E-YM

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:

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 (Chapter 31, Title 38, U.S. Code)	VA Form 28-1904 (8-28-14).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 %

	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

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.