Employment Questionnaire (VA Form 21-4140)

OMB 2900-0079

OMB 2900-0079

VA Forms 21-4140 and 21-4140-1 are to be used to gather information that is necessary to determine a recipient's continued entitlement to individual unemployability benefits. Without information about recipients' employment, VA would not be able to determine continued entitlement, and overpayments would result.

The latest form for Employment Questionnaire (VA Form 21-4140) expires 2020-10-31 and can be found here.

All Historical Document Collections
Revision of a currently approved collection 2024-07-09
Approved without change
Reinstatement without change of a previously approved collection 2021-05-24
Approved without change
Revision of a currently approved collection 2017-07-28
Approved without change
Revision of a currently approved collection 2014-10-03
Approved without change
Extension without change of a currently approved collection 2011-08-26
Approved without change
Extension without change of a currently approved collection 2008-06-18
Approved without change
Reinstatement with change of a previously approved collection 2005-05-11
Approved without change
No material or nonsubstantive change to a currently approved collection 2002-10-31
Approved without change
Reinstatement without change of a previously approved collection 2000-04-28
Withdrawn and continue
Extension without change of a currently approved collection 1995-08-28
Approved without change
Extension without change of a currently approved collection 1993-05-19
Approved without change
Extension without change of a currently approved collection 1990-06-21
Approved without change
Extension without change of a currently approved collection 1987-07-27
Approved without change
Revision of a currently approved collection 1984-06-19
Approved without change
Revision of a currently approved collection 1981-06-02
Approved with change
No material or nonsubstantive change to a currently approved collection 1981-01-26
Approved without change
Revision of a currently approved collection 1977-04-11

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