Information Collection

Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

IC 28273 under ICR 202211-2900-018 · OMB 2900-0099.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 22-5495 Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Form
22-5495 Dependents' Request for Change of Program or Place of Tr VA Form 22-5495 (OMB Exp. 2-28-23).pdf www.va.gov/vaforms	Form
22-5495 Dependents' Request for Change of Program or Place of Tr VA Form 22-5495 (OMB Exp. 2-28-23).pdf www.va.gov/vaforms	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.4234

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	22-5495	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	VA Form 22-5495 (OMB Exp. 2-28-23).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: Compensation, Pension, Education and Veteran Readiness and Employment Records-VA (58VA21/22/28)

FR Citation: 84 FR 4138

Number of Respondents: 45,434

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45,434	-64,326	109,760
Annual IC Time Burden (Hours)	11,358	-16,082	27,440
Annual IC Cost Burden (Dollars)	0	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.