Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution

Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193)

OMB: 2900-0116

IC ID: 28320

Information Collection (IC) Details

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Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution 2900-0116 VBA-COMP-YM
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA 21-4193 Notice to Department of Veterans Affairs of Veteran or Benefiiciary Incarcerated in Penal Institution VBA-21-4193-ARE 12-21-2016.pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

1,664 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,664 0 0 0 0 1,664
Annual IC Time Burden (Hours) 416 0 0 0 0 416
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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