Information Collection

Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))

IC 28354 under ICR 202202-2900-003 · OMB 2900-0132.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0132 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))	Form
Screenshot - VA 26-4555 Electronic Application Update.pdf	Other-Electronic Application
Screenshot - VA 26-4555 Electronic Application for Update in SAHSHA.pdf	Other-Electronic Application
VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Sp VA Form 26-4555 (OMB Expiring 9-30-21).pdf www.va.gov/vaforms	Form
VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Sp VA Form 26-4555 (OMB Expiring 9-30-21).pdf www.va.gov/vaforms	Form
VA 26-4555 VETERAN'S APPLICATION IN ACQUIRING SPECIALLY ADAPTED HOU New Electronic VA 26-4555 for Business Platform(SQB version) FO Review.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant (Title 38 U.S.C. Section 2101(a) or 2101(b))

Agency IC Tracking Number:

2900-0132

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.809 38 CFR 1.576

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	VA Form 26-4555	Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant	VA Form 26-4555 (OMB Expiring 9-30-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form and Instruction	VA 26-4555	VETERAN'S APPLICATION IN ACQUIRING SPECIALLY ADAPTED HOUSING OR SPECIAL HOME ADAPTATION GRANT	New Electronic VA 26-4555 for Business Platform(SQB version) FO Review.pdf		Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Loan Guaranty Home, Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant Records - VA (55VA26)

FR Citation: 79 FR 3922

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 15 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	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.