View Information Collection (IC)

View Information Collection (IC)

IC Title:	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)	Agency IC Tracking Number:	2900-0014 VBA-VR&E-DB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 48 CFR 871.201-2 38 CFR 21.332 38 CFR 21.320 38 CFR 21.294 38 CFR 21.321 38 CFR 21.322

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	28-1905	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status	28-1905.pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	90,000	0	0	0	0	90,000
Annual IC Time Burden (Hours)	7,500	0	0	0	0	7,500
Annual IC Cost Burden (Dollars)	0	0	0	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.