Information Collection

VA Fiduciary's Account (VA Form 21P-4706b), Court Appointed Fiduciary's Account (VA Form 21P-4706c) Certificate of Bal. on Deposit and Auth. to Disclose Financial Record (VA Form 21P-4718a)

IC 28106 under ICR 202407-2900-006 · OMB 2900-0017.

Documents and Forms

Document Name Document Type
Form 21P-4706b VA Fiduciary's Account (VA Form 21P-4706b), Court Appointed Fiduciary's Account (VA Form 21P-4706c) Certificate of Bal. on Deposit and Auth. to Disclose Financial Record (VA Form 21P-4718a) Form
21P-4706b VA Fiduciary's Account 21P-4706b(9-18-24).pdf www.va.gov/vaforms Form
21P-4706b VA Fiduciary's Account 21P-4706b(9-18-24).pdf www.va.gov/vaforms Form
21P-4706c Court Appointed Fiduciary's Account 21P-4706c(7-11-24).pdf www.va.gov/vaforms Form
21P-4706c Court Appointed Fiduciary's Account 21P-4706c(7-11-24).pdf www.va.gov/vaforms Form
21P-4718a Certificate of Balance on Deposit and Authorization to D 21P-4718a(7-11-24).pdf www.va.gov/vaforms Form
21P-4718a Certificate of Balance on Deposit and Authorization to D 21P-4718a(7-11-24).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VA Fiduciary's Account (VA Form 21P-4706b), Court Appointed Fiduciary's Account (VA Form 21P-4706c) Certificate of Bal. on Deposit and Auth. to Disclose Financial Record (VA Form 21P-4718a)	Agency IC Tracking Number:	2900-0017

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 13.200 38 CFR 13.210 38 CFR 13.280

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-4706b	VA Fiduciary's Account	21P-4706b(9-18-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P-4706c	Court Appointed Fiduciary's Account	21P-4706c(7-11-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P-4718a	Certificate of Balance on Deposit and Authorization to Disclose Financial Record	21P-4718a(7-11-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA 21/22/28 Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),	FR Citation: 84 FR 4138

Number of Respondents: 30,000	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	30,000	-23,159	53,159
Annual IC Time Burden (Hours)	10,000	-7,720	17,720
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.