Information Collection

Lay/Witness Statement (VA Form 21-10210)

IC 242781 under ICR 202403-2900-003 · OMB 2900-0881.

Documents and Forms

Document Name Document Type
Form 21-10210 Lay/Witness Statement (VA Form 21-10210) Form and Instruction
21-10210 Lay/Witness Statement VBA-21-10210-ARE.pdf www.va.gov/vaforms Form and Instruction
21-10210 Lay/Witness Statement VBA-21-10210-ARE.pdf www.va.gov/vaforms Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Lay/Witness Statement (VA Form 21-10210)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 3.303 38 CFR 3.159

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	21-10210	Lay/Witness Statement	VBA-21-10210-ARE.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, Veteran Readiness and Employment Records-VA (58VA21/22/28)	FR Citation: 87 FR 8740

Number of Respondents: 64,603	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	64,603	-35,397	100,000
Annual IC Time Burden (Hours)	10,767	-5,900	16,667
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.