Information Collection

Conflicting Interests Certification for Proprietary Schools Only

IC 28934 under ICR 202312-2900-004 · OMB 2900-0657.

Documents and Forms

Document Name Document Type
Form 22-1919 Conflicting Interests Certification for Proprietary Schools Only Form
22-1919 Conflicting Interests Certification for Proprietary Scho VA Form 22-1919 (OMB Exp. 3-31-23).pdf www.va.gov/vaforms Form
22-1919 Conflicting Interests Certification for Proprietary Scho VA Form 22-1919 - New Burden Statement (508 Conformant 3-8-24) 3-27-24.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Conflicting Interests Certification for Proprietary Schools Only	Agency IC Tracking Number:	2900-0657

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.7122(e)(6) 38 CFR 21.7622(f)(4)(iv) 38 CFR 21.4202(c) 38 CFR 21.5200(c) 38 CFR 21.4200(z)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	22-1919	Conflicting Interests Certification for Proprietary Schools Only	VA Form 22-1919 - New Burden Statement (508 Conformant 3-8-24) 3-27-24.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, Veteran Readiness and Employment Records - VA 58VA21/22/28	FR Citation: 84 FR 4138

Number of Respondents: 236	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	236	-100	336
Annual IC Time Burden (Hours)	39	-17	56
Annual IC Cost Burden (Dollars)	0	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.