Information Collection

Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

IC 28273 under ICR 201406-2900-033 · OMB 2900-0099.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0099 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 22-5495 Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) Form
VA Form 22-5495 Dependents' Request for Change of Program or Place of Tr VA Form 22-5495 (DOMA 6-18-14).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Agency IC Tracking Number:	2900-0099 VBA-EDU-YM

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.4234

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 22-5495	Dependents' Request for Change of Program or Place of Training	VA Form 22-5495 (DOMA 6-18-14).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 144,333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Previously Approved
Annual Number of Responses for this IC	144,333	144,333
Annual IC Time Burden (Hours)	36,083	36,083
Annual IC Cost Burden (Dollars)	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.