Statement of Disappearance

Statement of Disappearance (VA Form 21P-1775)

Documents and Forms

Document Name Document Type
Form 21P-1775 Statement of Disappearance Form
21P-1775 Statement of Disappearance VA Form 21P-1775-ARE (OMB Exp. 12-31-22).pdf www.va.gov/vaforms Form
21P-1775 Statement of Disappearance VA Form 21P-1775-ARE (OMB Exp. 12-31-22).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Statement of Disappearance	Agency IC Tracking Number:	2900-0036 VBA-COMP-NK

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-1775	Statement of Disappearance	VA Form 21P-1775-ARE (OMB Exp. 12-31-22).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)	FR Citation: 84 FR 4138

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	28	28
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.