Employment Questionnaire (VA Form 21-4140)

ICR 202404-2900-003

OMB: 2900-0079

Federal Form Document

Forms and Documents

Document Name	Status
Form VA Form 21-4140 Employment Questionnaire (VA Form 21-4140) Form	Modified
2024-14839, 30-Day FRN (2900-0079, VAF21-4140).pdf Supplementary Document	2024-07-09
2024-09583, 60-Day FRN (VAF21-4140).pdf Supplementary Document	2024-06-26
2900-0079, Supporting Statement (VAF21-4140).docx Supporting Statement A	2024-07-09

IC Document Collections

IC ID	Document Title	Status
28229	Employment Questionnaire (VA Form 21-4140) Form	Modified