Information Collection

Application for Accreditation as Service Organization Representative

IC 28110 under ICR 201910-2900-005 · OMB 2900-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0018 can be found here:

Documents and Forms

Document Name Document Type
Form VA21 Application for Accreditation as Service Organization Representative Form
VA21 APPLICATION FOR ACCREDITATION AS SERVICE ORGANIZATION RE VA21 - SEP 2019.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Accreditation as Service Organization Representative	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 14.626 38 CFR 14.633(b) 38 CFR 14.629(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA21	APPLICATION FOR ACCREDITATION AS SERVICE ORGANIZATION REPRESENTATIVE	VA21 - SEP 2019.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,713	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

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	4,713	1,556	3,157
Annual IC Time Burden (Hours)	1,013	231	782
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.