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Federal forms, ICRs, and supporting documents

Information Collection Request

Application of Service Representative for Placement on Mailing List

ICR 199909-2900-002 · OMB 2900-0028 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28124 Application of Service Representative for Placement on Mailing List Form Migrated
ICR Details
2900-0028 199909-2900-002
Historical Active 199508-2900-004
VA
Application of Service Representative for Placement on Mailing List
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 11/02/1999
Retrieve Notice of Action (NOA) 09/03/1999
Approved for use through 11/2002 under the condition that the VA immediately incorporates the new disclosure statements mandated by the Paperwork Reduction Act of 1995. For the public record, the VA must submit to OMB the revised forms/instructions.
  Inventory as of this Action Requested Previously Approved
11/30/2002 11/30/2002
150 0 0
25 0 0
0 0 0
The form is used to process requests from service organizations to be placed on the mailing list for specific VA publications.
None
None
No
1
IC Title Form No. Form Name
Application of Service Representative for Placement on Mailing List 3215
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 150 0 0 150 0 0
Annual Time Burden (Hours) 25 0 0 25 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/03/1999