Fiduciary Agreement

Fiduciary Agreement (21P-4703)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0319 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 21P-4703 Fiduciary Agreement Form
VA Form 21P-4703 Fiduciary Agreement VA Form 21P-4703 (7-24-13).pdf www.va.go/vaforms Form

Information Collection (IC) Details

IC Title:	Fiduciary Agreement	Agency IC Tracking Number:	2900-0319 VBA-P&F-YM

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 38 CFR 13.61 38 CFR 13.57 38 CFR 13.62 38 CFR 13.63 38 CFR 13.58

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21P-4703	Fiduciary Agreement	VA Form 21P-4703 (7-24-13).pdf	www.va.go/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28 "Compensation, Pension, Education and Rehabilitation Records- VA"	FR Citation: 74 FR 117

Number of Respondents: 17,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	17,600	17,600
Annual IC Time Burden (Hours)	1,467	1,467
Annual IC Cost Burden (Dollars)	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.