Information Collection

Lay/Witness Statement (VA Form 21-10210)

IC 242781 under ICR 202403-2900-003 · OMB 2900-0881.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-10210 Lay/Witness Statement (VA Form 21-10210)	Form and Instruction
Form 21-10210 Lay/Witness Statement Lay/Witness Statement (VA Form 21-10210)	Form and Instruction
21-10210 Lay/Witness Statement VBA-21-10210-ARE.pdf	Form and Instruction
21-10210 Lay/Witness Statement VBA-21-10210-ARE.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 3.303 38 CFR 3.159

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 and Instruction	21-10210			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

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

FR Citation: 87 FR 8740

Number of Respondents: 64,603

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	64,603	-35,397	100,000
Annual IC Time Burden (Hours)	10,767	-5,900	16,667
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.

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