Information Collection

Authorization To Disclose Personal Information To A Third Party

IC 253399 under ICR 202506-2900-008 · OMB 2900-0914.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 22-10278 AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY	Form and Instruction
Form 22-10278 Authorization to Disclose Personal Information to a Third Party - Education Benefits AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY	Form and Instruction
22-10278 Authorization to Disclose Personal Information to a Thir VBA-22-10278-ARE 8-29-25.pdf www.va.gov/vaforms	Form and Instruction
22-10278 Authorization to Disclose Personal Information to a Thir VBA-22-10278-ARE 8-29-25.pdf www.va.gov/vaforms	Form and Instruction

IC Title:

AUTHORIZATION TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY

Agency IC Tracking Number:

2900-NEW

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 1.576(b).

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	22-10278			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title: 58VA 21/22/28 Compensation Pension Education and Veteran Readiness and Employment Records â VA (58VA21/22/28)

FR Citation: 87 FR 17199

Number of Respondents: 322

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	322	-19,678	20,000
Annual IC Time Burden (Hours)	27	-1,640	1,667
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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