Information Collection

Voluntary Appeal File Brochure

IC 11851 under ICR 202511-1110-001 · OMB 1110-0043.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form unNumbered Voluntary Appeal File Brochure	Form and Instruction
Form unNumbered Voluntary Appeal File (VAF) Application Form Voluntary Appeal File Brochure	Form and Instruction
unNumbered Voluntary Appeal File (VAF) Application Form 1110-0043_Revised VAF Application.docx	Form and Instruction
unNumbered Voluntary Appeal File (VAF) Application Form 1110-0043_VAF Application_Revised.docx	Form and Instruction
Privacy Act Statement Screenshot.png Privacy Act Statement Screenshot for Online VAF Application	IC Document
Privacy Act Statement Screenshot.png Privacy Act Statement Screenshot for Online VAF Application	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	unNumbered				Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,073

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,073	7,336	3,737
Annual IC Time Burden (Hours)	5,537	3,668	1,869
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Privacy Act Statement Screenshot for Online VAF Application		07/11/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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