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Federal forms, ICRs, and supporting documents

Information Collection Request

Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR

ICR 200510-2900-005 · 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
28126 Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR Form Migrated
ICR Details
2900-0028 200510-2900-005
Historical Active 200209-2900-004
VA
Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR
Extension without change of a currently approved collection   No
Regular
Approved without change 11/29/2005
Retrieve Notice of Action (NOA) 10/06/2005
Approved consistent with the following term of clearance: in the next submission of this collection of information to OMB for approval VA shall report on progress to providing fully electronic versions of associated forms to respondents which may be completed and submitted electronically.
  Inventory as of this Action Requested Previously Approved
11/30/2008 11/30/2008 10/31/2005
196,200 0 196,200
22,700 0 22,700
0 0 0
3215 is used to process requests from service organizations to be place 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 196,200 196,200 0 0 0 0
Annual Time Burden (Hours) 22,700 22,700 0 0 0 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.
10/06/2005