Information Collection

Edith Nourse Rogers STEM Scholarship Application

IC 237068 under ICR 202301-2900-012 · OMB 2900-0878.

Documents and Forms

Document Name Document Type
Form 22-10203 Edith Nourse Rogers STEM Scholarship Application Form
22-10203 Edith Nourse Rogers STEM Scholarship Application VA Form 22-10203 (2-6-23).pdf www.va.gov/vaforms Form
22-10203 Edith Nourse Rogers STEM Scholarship Application VA Form 22-10203 (2-6-23).pdf www.va.gov/vaforms Form
22-10203-RogersSTEMScholarship-OMB-20200604 (002).pdf Digital Version IC Document
22-10203-RogersSTEMScholarship-OMB-20200604 (002).pdf Digital Version IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Edith Nourse Rogers STEM Scholarship Application	Agency IC Tracking Number:

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	22-10203	Edith Nourse Rogers STEM Scholarship Application	VA Form 22-10203 (2-6-23).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

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

Number of Respondents: 16,752	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,752	16,002	750
Annual IC Time Burden (Hours)	4,188	-31,812	36,000
Annual IC Cost Burden (Dollars)	124,635	124,635	0

Documents for IC

Title	Document	Date Uploaded
Digital Version	22-10203-RogersSTEMScholarship-OMB-20200604 (002).pdf	06/09/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.