View Information Collection (IC)
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View Information Collection (IC)
View Information Collection (IC)
IC Title:
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr
Agency IC Tracking Number:
VHA-2900-0793
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
38 CFR Part 17 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA form 10-0491
Academic Verification
VA Form 10-0491_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491c
Annual VA Employment or Deferment Verification
VA Form 10-0491c_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491d
Obligated Service
VA Form 10-0491d_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491e
Evaluation and Recommendation Form
VA Form 10-0491e_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form and Instruction
VA Form 10-0491g
Application
VA Form 10-0491g_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491h
Notice of Expected Graduation
VA Form 10-0491h_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491i
Notice of Change (NOC)
VA Form 10-0491i_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491j
Request for Deferment
VA Form 10-0491j_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Form
VA Form 10-0491k
VA Scholarship Offer Response
VA Form 10-0491k_updated 2026_draft.pdf
http://vaww.va.gov/vaforms/
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
Privacy Act of 1974, as amended
FR Citation:
71 FR 60232
Number of Respondents:
2,050
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Requested
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
2,050
0
2,050
0
0
0
Annual IC Time Burden (Hours)
8,017
0
8,017
0
0
0
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.
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