OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781)

IC 28937 under ICR 202311-2900-013 · OMB 2900-0659.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781) 2900-0659
 
No Modified
 
Voluntary
 
38 CFR 3.304(f)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 21-0781 Statement in Support of Claimed Mental Health Disorder(s) Due to an In Service Traumatic Event(s) 21-0781(3-28-24).pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)  89 FR 86220

116,581 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 116,581 0 96,207 0 0 20,374
Annual IC Time Burden (Hours) 87,436 0 63,666 0 0 23,770
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.