Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193)

ICR 202506-2900-007

Forms and Documents

Document Name	Status
Form VBA-21-4193 Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193) Form	Modified
30-Day (published) 2900-0116.pdf Supplementary Document	2025-08-28
2025-11957, 60-Day FRN (2900-0116, VAF21-4193).pdf Supplementary Document	2025-06-27
2900-0116, Supporting Statement 8-28-25.docx Supporting Statement A	2025-08-28

IC Document Collections

IC ID	Document Title	Status
28320	Notice to Department of Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution (VA Form 21-4193) Form	Modified

ICR Details