Information Collection

VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a)

IC 253236 under ICR 202410-2900-006 · OMB 2900-0915.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 20-10276 VBA Contractor Background Investigation Request (VA Form 20-10276), VBA Affiliate Background Investigation Request (VA Form 20-10276a)	Form
20-10276 VBA Contractor Background Investigation Request VA Form 20-10276 (New Burden Statement) 12-23-24.pdf www.v.gov/vaforms	Form
20-10276a VBA Affiliate Background Investigation Request VA Form 20-10276a (508 Conformant 11-14-24).pdf www.va.gov/vaforms	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 731

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	20-10276	VBA Contractor Background Investigation Request	VA Form 20-10276 (New Burden Statement) 12-23-24.pdf	www.v.gov/vaforms	Yes	No	Fillable Printable
Form	20-10276a	VBA Affiliate Background Investigation Request	VA Form 20-10276a (508 Conformant 11-14-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Police and Security Records - VA (103VA07B)

FR Citation: 73 FR 74580

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	10,000	5,000	5,000
Annual IC Time Burden (Hours)	2,167	1,334	833
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.