Information Collection

Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants

IC 250256 under ICR 202107-2900-003 · OMB 2900-0899.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0899 can be found here:

Documents and Forms

Document Name Document Type
Form 19-264D Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants Form and Instruction
19-264D Education Program Completion Notice VA Form 10-264D.pdf Form and Instruction
19-264D Education Program Completion Notice VA Form 10-264D.pdf Form and Instruction
10-264F Scholarship Agreement VA Form 10-264F.pdf Form and Instruction
10-264F Scholarship Agreement VA Form 10-264F.pdf Form and Instruction
10-264H Notice of Approaching Graduation VA Form 10-264H.pdf Form and Instruction
10-264H Notice of Approaching Graduation VA Form 10-264H.pdf Form and Instruction
10-264I Notice of Change and-or Academic Status VA Form 10-264I.pdf Form and Instruction
10-264I Notice of Change and-or Academic Status VA Form 10-264I.pdf Form and Instruction
10-264J Request for Deferment VA Form 10-264J.pdf Form and Instruction
10-264J Request for Deferment VA Form 10-264J.pdf Form and Instruction
10-264K Scholarship Offer Response VA Form 10-264K.pdf Form and Instruction
10-264K Scholarship Offer Response VA Form 10-264K.pdf Form and Instruction
10-264M Mobility Agreement VA Form 10-264M.pdf Form and Instruction
10-264M Mobility Agreement VA Form 10-264M.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Readjustment Counseling Service Scholarship Program (RCSSP) - Selected Participants	Agency IC Tracking Number:	2900-NEW

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	19-264D	Education Program Completion Notice	VA Form 10-264D.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264F	Scholarship Agreement	VA Form 10-264F.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264H	Notice of Approaching Graduation	VA Form 10-264H.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264I	Notice of Change and-or Academic Status	VA Form 10-264I.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264J	Request for Deferment	VA Form 10-264J.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264K	Scholarship Offer Response	VA Form 10-264K.pdf	Yes	No	Fillable Printable
Form and Instruction	10-264M	Mobility Agreement	VA Form 10-264M.pdf	Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	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.