Information Collection

Statement of Accredited Representative in Appealed Case

IC 28158 under ICR 201507-2900-003 · OMB 2900-0042.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 646 Statement of Accredited Representative in Appealed Case	Form
646 Statement of Accredited Representative Appealed Case VA Form 646 (Jun 2015).pdf www.va.gov/vaforms/	Form

IC Title:

Agency IC Tracking Number:

2900-0042

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 20.600

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	646	Statement of Accredited Representative Appealed Case	VA Form 646 (Jun 2015).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: 50,286

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50,286	5,735	44,551
Annual IC Time Burden (Hours)	50,286	5,735	44,551
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.