Information Collection

REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377) (21-8941)

IC 28620 under ICR 201708-2900-016 · OMB 2900-0405.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0405 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-8941 REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377) (21-8941) Form
21P-8941 REPS Annual Eligibility Report (Under the Provisions of VA Form 21P-8941 (508 Conformant 9-6-17).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377) (21-8941)	Agency IC Tracking Number:	2900-0405 VBA-COMP-DB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.812

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-8941	REPS Annual Eligibility Report (Under the Provisions of Section 156, Public Law 97-377)	VA Form 21P-8941 (508 Conformant 9-6-17).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)	FR Citation: 77 FR 42593

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,200	0	1,200
Annual IC Time Burden (Hours)	300	0	300
Annual IC Cost Burden (Dollars)	7,155	7,155	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.