Information Collection

Application for Reimbursement of Licensing or Certification Test Fees

IC 179084 under ICR 201801-2900-012 · OMB 2900-0695.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0695 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 22-0803 Application for Reimbursement of Licensing or Certification Test Fees	Form
VA Form 22-0803 Application for Reimbursement of Licensing or Certificat 22-0803(2-1-18).pdf www.va.gov/vaforms	Form

IC Title:

Application for Reimbursement of Licensing or Certification Test Fees

Agency IC Tracking Number:

2900-0695

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.7140(c)(4) 38 CFR 21.1030

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 22-0803	Application for Reimbursement of Licensing or Certification Fees	22-0803(2-1-18).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Compensation, Pension, Education and Vocational Rehabilitation Records â VA (58VA21/22/28)

FR Citation: 73 FR 29181

Number of Respondents: 2,641

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	2,641	1,010	1,631
Annual IC Time Burden (Hours)	660	252	408
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.