Appointment of Veterans Service Organization as Claimant's Representative (VAF21-22), Appointment of Individual as Claimant's Representative (VAF21-21-22a)

Appointment of Veterans Service Organization as Claimant's Representative (VA Form 21-22), Appointment of Individual as Claimant's Representative (VA Forms 21-22a)

Documents and Forms

Document Name Document Type
Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative (VAF21-22), Appointment of Individual as Claimant's Representative (VAF21-21-22a) Form
21-22 Appointment of Veterans Service Organization as Claimant VA Form 21-22 (508 Conformant 1-20-23).pdf www.va.gov/vaforms Form
21-22 Appointment of Veterans Service Organization as Claimant VA Form 21-22 (508 Conformant 1-20-23).pdf www.va.gov/vaforms Form
21-22a Appointment of Individual as Claimant's Representative VAF21-22a FINAL Copy (6-12-23).pdf www.va.gov/vaforms Form
21-22a Appointment of Individual as Claimant's Representative VAF21-22a FINAL Copy (6-12-23).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Appointment of Veterans Service Organization as Claimant's Representative (VAF21-22), Appointment of Individual as Claimant's Representative (VAF21-21-22a)	Agency IC Tracking Number:	2900-0321

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 14.631 38 CFR 1.525

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-22	Appointment of Veterans Service Organization as Claimant's Representative	VA Form 21-22 (508 Conformant 1-20-23).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21-22a	Appointment of Individual as Claimant's Representative	VAF21-22a FINAL Copy (6-12-23).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28 Compensation, Pension, Education, Veterans Readiness and Employment Records	FR Citation: 88 FR 13022

Number of Respondents: 735,004	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	735,004	415,999	319,005
Annual IC Time Burden (Hours)	61,249	34,666	26,583
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.