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

Appointment of Veterans Service Organization as Claimant's Representative and Appointment of Individual as Claimant's Representative (VA Forms 21-22 and 21-22a)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 21-22 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(2-5-15).pdf www.va.gov/vaforms/ Form
21-22A Appointment of Individual as Claimant's Representative 21-22A(2-5-15).pdf www.va.gov/vaforms/ Form

Information Collection (IC) Details

IC Title:	Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative	Agency IC Tracking Number:

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-22	Appointment of Veterans Service Organization as Claimant's Representative	21-22(2-5-15).pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable
Form	21-22A	Appointment of Individual as Claimant's Representative	21-22A(2-5-15).pdf	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 %

	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

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.