Information Collection

Application for Accreditation as Service Organization Representative

IC 28110 under ICR 202604-2900-015 · OMB 2900-0018.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21 Application for Accreditation as Service Organization Representative Application for Accreditation as Service Organization Representative	Form
Form VA Form 21 (ES) Application for Accreditation as Service Organization Representative Application for Accreditation as Service Organization Representative	Form
VA Form 21 Application for Accreditation as Service Organization Re VA21 (DRAFT 20260114).pdf	Form
VA Form 21 (ES) Application for Accreditation as Service Organization Re VA21_ES (DRAFT 20260114).pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0018

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 14.626 38 CFR 14.629(a) 38 CFR 14.633(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	VA Form 21				No		Fillable Printable
Form	VA Form 21 (ES)				No		Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Accreditation Records-VA

FR Citation: 78 FR 77205

Number of Respondents: 4,510

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,510	4,510
Annual IC Time Burden (Hours)	1,010	1,010
Annual IC Cost Burden (Dollars)	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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