OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative

ICR 200901-2900-015 · OMB 2900-0321 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative Form Modified Available
2900-0321 justification.doc Supporting Statement A Uploaded 2009-05-18 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28538 Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative Form Modified
ICR Details
2900-0321 200901-2900-015
Historical Active 200604-2900-009
VA 2900-0321
Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative
Extension without change of a currently approved collection   No
Regular
Approved without change 08/19/2009
Retrieve Notice of Action (NOA) 06/04/2009
  Inventory as of this Action Requested Previously Approved
08/31/2012 36 Months From Approved 08/31/2009
331,400 0 331,400
27,616 0 27,616
0 0 0
VA Forms 21-22 and 21-22a are used to gather information that is necessary to determine whom claimants have appointed to represent them in claims for VA benefits. Without this information, VA would be unable to determine whom has been appointed as the representative, the extent of the representation, and access to appropriate records.
US Code: 38 USC 5902 Name of Law: Recognition of representatives of organizations
   US Code: 38 USC 5903 Name of Law: Recognition with respect to particular claims
   US Code: 38 USC 5701 Name of Law: Confidential nature of claims
   US Code: 38 USC 7332 Name of Law: Confidentiality of certain medical records
   US Code: 38 USC 5702 Name of Law: Furnishing of records
  
None
Not associated with rulemaking
  74 FR 26 02/10/2009
74 FR 77 04/23/2009
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 331,400 331,400 0 0 0 0
Annual Time Burden (Hours) 27,616 27,616 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$2,770,836
No
No
Uncollected
Uncollected
No
Uncollected
Denise McLamb 202-565-8374 [email protected]
  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.
06/04/2009