OMB
.report
Search
Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)
Dependent's Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) (22-5495)
OMB: 2900-0099
IC ID: 28273
OMB.report
VA
OMB 2900-0099
ICR 201406-2900-033
IC 28273
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0099 can be found here:
2023-02-10 - Revision of a currently approved collection
2020-08-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form VA Form 22-5495
Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)
Form
VA Form 22-5495 Dependents' Request for Change of Program or Place of Tr
VA Form 22-5495 (DOMA 6-18-14).pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)
Agency IC Tracking Number:
2900-0099 VBA-EDU-YM
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
38 CFR 21.4234
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA Form 22-5495
Dependents' Request for Change of Program or Place of Training
VA Form 22-5495 (DOMA 6-18-14).pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Higher Education
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
144,333
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
20 %
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
144,333
0
0
0
0
144,333
Annual IC Time Burden (Hours)
36,083
0
0
0
0
36,083
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.