Information Collection

Application for Accreditation as a Claims Agent or Attorney, Filing of Representatives' Fee Agreements and Motions for Review of Such Fee Agreements

IC 28847 under ICR 201710-2900-006 · OMB 2900-0605.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0605 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA21a Application for Accreditation as a Claims Agent or Attorney, Filing of Representatives' Fee Agreements and Motions for Review of Such Fee Agreements	Form and Instruction
VA21a Application for Accreditation as a Claims Agent or Attor VA21a SEP 2019.pdf www.va.gov/vaforms	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Application for Accreditation as a Claims Agent or Attorney, Filing of Representatives' Fee Agreements and Motions for Review of Such Fee Agreements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 14.629(a)-(b) 38 CFR 14.626 38 CFR 14.633(b) 38 CFR 14.636(g)(3)

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 and Instruction	VA21a	Application for Accreditation as a Claims Agent or Attorney	VA21a SEP 2019.pdf	www.va.gov/vaforms	No		Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: as Compensation, Pension, Education and Vocational Rehabilitation and Employment RecordsâVA, 58VA21/22/28; Veterans Appellate Records SystemâVA, 44VA01; and Accreditation RecordsâVA, 01VA022

FR Citation: 73 FR 51348

Number of Respondents: 21,560

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	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	21,560	18,910	2,650
Annual IC Time Burden (Hours)	5,683	1,153	4,530
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.