OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

a. Application of Service Reresentative for Placement on Mailing List b. Request for and Consen to Release of Information from Claimant's Records c. Requests to Corespondent for Identifing....

ICR 200209-2900-004 · 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
28125 a. Application of Service Reresentative for Placement on Mailing List b. Request for and Consen to Release of Information from Claimant's Records c. Requests to Corespondent for Identifing.... Form Migrated
ICR Details
2900-0028 200209-2900-004
Historical Active 199909-2900-002
VA
a. Application of Service Reresentative for Placement on Mailing List b. Request for and Consen to Release of Information from Claimant's Records c. Requests to Corespondent for Identifing....
Extension without change of a currently approved collection   No
Regular
Approved without change 10/18/2002
Retrieve Notice of Action (NOA) 09/05/2002
This revision combines 2900-0025, 2900-0078, and 2900-0438 into 2900-0028. In the next submission of this package, VA will provide one supporting statement that addresses the pertinent information for all four collections.
  Inventory as of this Action Requested Previously Approved
10/31/2005 10/31/2005 11/30/2002
196,200 0 150
22,700 0 25
0 0 0
3215 is used to process requests from service organizations to be placed on specific VA publications mailing list. 3288 is completed by VA beneficiaries to provide VA with written consent to release records or information to a third party. 70-2 is used to get additional information from a correspondent when the incoming correspondence does not give enough information to identify a specific veteran. Information collected for list of names and addresses is used to determine whether an applicant is eligible to receive an address list.
None
None
No
  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 196,200 150 0 0 196,050 0
Annual Time Burden (Hours) 22,700 25 0 0 22,675 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
09/05/2002