Operation Enduring Freedom/Operation Iraqi Freedom Seriously Injured/Ill Service Member Veteran Worksheet

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0720 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 21-0773 Operation Enduring Freedom/Operation Iraqi Freedom Seriously Injured/Ill Service Member Veteran Worksheet Form
VA Form 21-0773 Operation Enduring Freedom/Operation Iraqi Freedom Serio 21-0773.pdf www.va.gov.vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Operation Enduring Freedom/Operation Iraqi Freedom Seriously Injured/Ill Service Member Veteran Worksheet	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-0773	Operation Enduring Freedom/Operation Iraqi Freedom Seriously Injured/ILL Servicemember/Veteran Worksheet	21-0773.pdf	www.va.gov.vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14,000	13,847	153
Annual IC Time Burden (Hours)	7,000	6,923	77
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.