Information Collection

Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress

IC 28563 under ICR 201902-2900-008 · OMB 2900-0358.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 22-8873 Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress	Form
22-8873 SUPPLEMENTAL INFORMATION FOR CHANGE OF PROGRAM OR REENRO VA Form 22-8873 (508 Conformant 2-19-19).pdf www.va.gov/vaforms	Form

IC Title:

Agency IC Tracking Number:

2900-0358

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.5232 38 CFR 21.7614 38 CFR 21.7653 38 CFR 21.4234 38 CFR 21.4277 38 CFR 21.4278 38 CFR 21.7114 38 CFR 21.7153 38 CFR 21.5270

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	22-8873	SUPPLEMENTAL INFORMATION FOR CHANGE OF PROGRAM OR REENROLLMENT AFTER UNSATISFACTORY ATTENDANCE, CONDUCT OR PROGRESS	VA Form 22-8873 (508 Conformant 2-19-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17,720

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	17,720	-25,816	43,536
Annual IC Time Burden (Hours)	8,860	-12,909	21,769
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.