Information Collection

Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery

IC 28470 under ICR 201003-2900-012 · OMB 2900-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0222 can be found here:

Documents and Forms

Document Name Document Type
Form 40-1330 Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery Form and Instruction
40-1330 Application for Standard Headstone or Marker for Install VA40-1330.pdf www.va.gov/vaforms/va/pdf/40-1330.pdf Form and Instruction
VA Form 40-1330M Claim for government Medallion for Installation in a Pri VA40-1330M.pdf www.va.gov/vaforms/va/pdf/40-1330M.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Standard Government Headstone or Marker for Installation in Private or State Veterans Cemetery	Agency IC Tracking Number:	2900-0222

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 1.632 38 CFR 38.632

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	40-1330	Application for Standard Headstone or Marker for Installation in a Private or State Veterans' Cemetery	VA40-1330.pdf	http://www.va.gov/vaforms/va/pdf/40-1330.pdf	Yes	No	Printable Only
Form and Instruction	VA Form 40-1330M	Claim for government Medallion for Installation in a Private Cemetery	VA40-1330M.pdf	http://www.va.gov/vaforms/va/pdf/40-1330M.pdf	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 374,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	374,000	40,000	334,000
Annual IC Time Burden (Hours)	93,500	10,000	83,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.