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OMB control number

Disability Benefits Questionnaires (21-0960A-1, 21-0960B-1, 21-0960C-1)

OMB 2900-0749 · VA.

OMB 2900-0749
Latest Forms, Documents, and Supporting Material
Document
Name
Form VA Form 21-0960A-1 Disability Benefits Questionnaires
Form
2017-01744, 30-Day FRN (2900-0749).pdf
Supplementary Document
2016-27489 (60-Day FRN, 2900-0749).pdf
Supplementary Document
2900-0749 (A-1, B-1, C-1), (2-10-17).doc
Supporting Statement A
Disability Benefits Questionnaires
Form
All Historical Document Collections
201610-2900-005
Approved without change
Extension without change of a currently approved collection 2017-02-16
201305-2900-001
Approved with change
Extension without change of a currently approved collection 2013-11-15
201009-2900-005
Approved without change
Extension without change of a currently approved collection 2010-12-29
201005-2900-009
Approved without change
New collection (Request for a new OMB Control Number) 2010-06-15

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