Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996)

Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996)

OMB: 2900-0862

IC ID: 232032

Information Collection (IC) Details

View Information Collection (IC)

Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996) VBA-AMO-YA
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
38 CFR 2501 38 CFR 2500 38 CFR 2601

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 20-0995 DECISION REVIEW REQUEST: SUPPLEMENTAL CLAIM VA Form 20-0995-NEW AMC (508 Compliant 9-13-18).pdf www.va.gov/vaforms Yes No Fillable Printable
Form 20-0996 DECISION REVIEW REQUEST: HIGHER-LEVEL REVIEW VA Form 20-0996 (IAI) 10-25-18.pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

58/VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records -VA  83 FR 39818

115,000 0
   
Individuals or Households
 
   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 115,000 0 115,000 0 0 0
Annual IC Time Burden (Hours) 28,750 0 28,750 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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