Information Collection Request
Pension Claim Questionnaire for Farm Income (VA Form 21P-4165)
ICR 202502-2900-011 · OMB 2900-0095 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 21P-4165 Pension Claim Questionnaire for Farm Income |
Form and Instruction | Modified | Repair queued |
 30-DAY (published) 2900-0095.pdf |
Supplementary Document | Uploaded 2025-08-26 | Repair queued |
| 60-Day FRN (published) 2900-0095.pdf |
Supplementary Document | Uploaded 2025-08-22 | Repair queued |
 2900-0095 (21P-4165) - Supporting Statement 8-26-25.docx |
Supporting Statement A | Uploaded 2025-08-26 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 28263 |  Pension Claim Questionnaire for Farm Income |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | VA |
| OMB Control No | 2900-0095 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202204-2900-013 |
| Agency Tracking No | VBA-P&F-YA |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |