OMB control number
Alternate Signer Certification (VA Form 21-0972)
OMB 2900-0849 ยท VA.
OMB 2900-0849
VA Form 21-0972 is used to collect the alternate signer information necessary for VA to accept benefit application forms signed by individuals on behalf of Veterans and claimants. The information collected is used to contact the alternate signer for verification purposes. Without this information, VA would be unable to verify information related to the alternate signer who has been appointed to represent the claimant in the prosecution of VA claims, the extent of such representation, and access to appropriate records.
The latest form for Alternate Signer Certification (VA Form 21-0972) expires 2029-05-31 and is listed under ICR 202512-2900-006.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 21-0972 Alternate Signer Certification | Form |
 Public comment for 2900-0849.docx | Public Comments |
| 30-Day FRN (published) 2900-0849.pdf | Supplementary Document |
| 60-Day FRN (published) 2900-0849.pdf | Supplementary Document |
| 2900-0849, Supporting Statement (VAF 21-0972) 1.docx | Supporting Statement A |
 Alternate Signer Certification |
Form |
| Alternate Signer Certification |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202512-2900-006 | Revision of a currently approved collection | 2026-02-26 | ||
| 202210-2900-006 | Revision of a currently approved collection | 2023-01-17 | Approved without change | |
| 201903-2900-014 | Reinstatement without change of a previously approved collection | 2019-12-10 | Approved without change | |
| 201603-2900-010 | New collection (Request for a new OMB Control Number) | 2016-07-18 | Approved without change |