Information Collection

VBA Contractor Background Investigation Request (VA Form 20-10276)

IC 253236 under ICR 202204-2900-016 · OMB 2900-0915.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0915 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 20-10276 VBA Contractor Background Investigation Request (VA Form 20-10276)	Form
20-10276 VBA Contractor Background Investigation Request VA Form 20-10276 (508 Conformant - 3-28-22).pdf vaww.va.gov/vaforms	Form
20-10276 VBA Contractor Background Investigation Request VA Form 20-10276 (508 Conformant - 3-28-22).pdf vaww.va.gov/vaforms	Form

IC Title:

VBA Contractor Background Investigation Request (VA Form 20-10276)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 731

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	20-10276	VBA Contractor Background Investigation Request	VA Form 20-10276 (508 Conformant - 3-28-22).pdf	vaww.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Police and Security Records - VA (103VA07B)

FR Citation: 73 FR 74580

Number of Respondents: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	833	833
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.