Information Collection

Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and....

IC 28106 under ICR 201905-2900-004 · OMB 2900-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0017 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-4706c Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and.... Form
21P-4706c COURT APPOINTED FIDUCIARY'S ACCOUNT VA Form 21P-4706c (508 Conformant 7-17-19 - OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form
21P-4718a CERTIFICATE OF BALANCE ON DEPOSIT AND AUTHORIZATION TO D VA Form -21P-4718a (508 Conformant 7-30-19 - OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form
21P4706b VA FIDUCIARY'S ACCOUNT VA Form 21P-4706b (OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and....	Agency IC Tracking Number:	2900-0017

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 13.200 38 CFR 13.210 38 CFR 13.280

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-4706c	COURT APPOINTED FIDUCIARY'S ACCOUNT	VA Form 21P-4706c (508 Conformant 7-17-19 - OMB Exp. 7-31-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P-4718a	CERTIFICATE OF BALANCE ON DEPOSIT AND AUTHORIZATION TO DISCLOSE FINANCIAL RECORDSÂ	VA Form -21P-4718a (508 Conformant 7-30-19 - OMB Exp. 7-31-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P4706b	VA FIDUCIARY'S ACCOUNT	VA Form 21P-4706b (OMB Exp. 7-31-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	33,500	-1,500	35,000
Annual IC Time Burden (Hours)	11,167	-500	11,667
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.