Information Collection

Request for Higher-Level Review (PL 115-55) (VA Form 20-0996)

IC 232032 under ICR 202011-2900-002 · OMB 2900-0862.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0862 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 20-0996 Request for Higher-Level Review (PL 115-55) (VA Form 20-0996)	Form
20-0996 DECISION REVIEW REQUEST: HIGHER-LEVEL REVIEW VA Form 20-0996 (9-9-20).pdf www.va.gov/vaforms	Form
20-0996 DECISION REVIEW REQUEST: HIGHER-LEVEL REVIEW VA Form 20-0996 (9-9-20).pdf www.va.gov/vaforms	Form

IC Title:

Request for Higher-Level Review (PL 115-55) (VA Form 20-0996)

Agency IC Tracking Number:

VBA-OAR-YA

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 2601

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	20-0996	DECISION REVIEW REQUEST: HIGHER-LEVEL REVIEW	VA Form 20-0996 (9-9-20).pdf	www.va.gov/vaforms	Yes	No	Fillable Fileable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: 58/VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records -VA

FR Citation: 84 FR 4138

Number of Respondents: 85,500

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	Previously Approved
Annual Number of Responses for this IC	85,500	-29,500	115,000
Annual IC Time Burden (Hours)	21,375	-7,375	28,750
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.