OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Appointment of Veterans Service Organization as Claimant's Representative (VA Form 21-22) and Appointment of Individual as Claimant's Representative (VA Forms 21-22a)

ICR 201805-2900-008 · OMB 2900-0321 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative 'and' Appointment of Individual as Claimant's Representative Form Modified Available
2018-18912.pdf Supplementary Document Uploaded 2018-10-16 Repair queued
SupportingState(2900-0321).docx Supporting Statement A Uploaded 2018-06-19 Available
2018-12331.pdf Supplementary Document Uploaded 2018-06-19 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 201805-2900-008
Active 201501-2900-011
VA VBA-COMP-NK
Appointment of Veterans Service Organization as Claimant's Representative (VA Form 21-22) and Appointment of Individual as Claimant's Representative (VA Forms 21-22a)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 02/07/2019
Retrieve Notice of Action (NOA) 10/16/2018
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved
319,005 0 0
26,583 0 0
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. VA Forms 21-22 and 21-22a are being revised to include new standardization data points; to include optical character recognition boxes. This is a non-substantive change.
US Code: 38 USC 5902 Name of Law: Recognition of representatives of organizations
   US Code: 38 USC 5701 Name of Law: Confidential nature of claims
   US Code: 38 USC 5903 Name of Law: Recognition with respect to particular 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
  83 FR 12331 06/08/2018
83 FR 18912 08/31/2018
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 319,005 0 0 -12,395 0 331,400
Annual Time Burden (Hours) 26,583 0 0 -1,033 0 27,616
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The number of respondents has decreased since last approval, thus the decrease in burden.
$3,370,105
No
    Yes
    Yes
No
No
No
Uncollected
Nancy Kessinger 202 632-8924 [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.
10/16/2018