Information Collection

Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6)

IC 206558 under ICR 201612-2900-010 · OMB 2900-0810.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0810 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-0960M-6 FOOT CONDITIONS, INCLUDING FLATFOOT (PES PLANUS) DISABILITY BENEFITS QUESTIONNAIRE Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6)	Form
VA Form 21-0960M-6 FOOT CONDITIONS, INCLUDING FLATFOOT (PES PLANUS) DISABIL VA Form 21-0960M-6 (508 Conformant 1-18-17).pdf	Form

IC Title:

Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6)

Agency IC Tracking Number:

2900-NEW VBA-COMP-DB

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 3.326 38 CFR 3.351

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	VA Form 21-0960M-6			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Compensation, Pension, Education, and Rehabilitation RecordsÂVA (58VA21/22/28)

FR Citation: 75 FR 29275

Number of Respondents: 80,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	80,000	80,000
Annual IC Time Burden (Hours)	40,000	40,000
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.

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