Information Collection Request
Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781)
ICR 202311-2900-013 · OMB 2900-0659 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form VA Form 21-0781 Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781) |
Form | Modified | Repair queued |
 2024-03148, 30-Day FRN (VAF21-0781).pdf |
Supplementary Document | Uploaded 2024-02-15 | Repair queued |
| 2023-27210, 60-Day FRN (VAF21-0781).pdf |
Supplementary Document | Uploaded 2024-02-15 | Repair queued |
 2900-0659 Supporting Statement (VAF21-0781).docx |
Supporting Statement A | Uploaded 2024-02-15 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 28937 |  Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781) |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | VA |
| OMB Control No | 2900-0659 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202009-2900-006 |
| Agency Tracking No | VBA-COMP-NK |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |