Information Collection

Decision Review Request: Supplemental Claim (VA Form 20-0995)

IC 244441 under ICR 202402-2900-006 · OMB 2900-0886.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 20-0995 Decision Review Request: Supplemental Claim (VA Form 20-0995)	Form
VA Form 20-0995 Decision Review Request: Supplemental Claim 20-0995(4-22-24).pdf www.va.gov/vaforms	Form
VA Form 20-0995 Decision Review Request: Supplemental Claim 20-0995(4-22-24).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 3.2501

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	VA Form 20-0995	Decision Review Request: Supplemental Claim	20-0995(4-22-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

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

FR Citation: 89 FR 28853

Number of Respondents: 640,477

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	640,477	375,477	265,000
Annual IC Time Burden (Hours)	160,119	93,869	66,250
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.