Information Collection

Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR

IC 28126 under ICR 201611-2900-001 · OMB 2900-0028.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3288 Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR	Form
3288 Request for Consent to Release of Information from Indiv VA3288.pdf www.va.gov/vaforms	Form
FL70-2 FL70-2 FL70-2.pdf www.va.gov/vaforms	Form
3215 Application of Service Representative for Placement on M VA3215.pdf www.va.gov/vaforms	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR

Agency IC Tracking Number:

2900-0028

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 1.576(b) 38 CFR 1.526(a) 38 CFR 1.519(A)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form	3288	Request for Consent to Release of Information from Individual's Records	VA3288.pdf	http://www.va.gov/vaforms	No	Paper Only
Form	FL70-2	FL70-2	FL70-2.pdf	http://www.va.gov/vaforms	No	Paper Only
Form	3215	Application of Service Representative for Placement on Mailing List	VA3215.pdf	http://www.va.gov/vaforms	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 196,200

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	196,200	196,200
Annual IC Time Burden (Hours)	22,700	22,700
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.