OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

35% exemption Request From 85-15 Reporting Requirement

IC 248396 under ICR 202408-2900-015 · OMB 2900-0896.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form VA Form 22-10216
35% exemption Request From 85-15 Reporting Requirement		 Form
Form VA Form 22-10216
35% Exemption Request From 85-15 Reporting Requirement 35% exemption Request From 85-15 Reporting Requirement		 Form
VA Form 22-10216 35% Exemption Request From 85-15 Reporting Requirement
22-10216(2-23-21).pdf 		Form
VA Form 22-10216 35% Exemption Request From 85-15 Reporting Requirement
22-10216(2-23-21).pdf 		Form

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 22-10216 www.va.gov/vaforms Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 0 0 0 -1,000 0 1,000
Annual IC Time Burden (Hours) 0 0 0 -500 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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