Request For Personal Identity Verification Card

Request for One-VA Identification Card

Documents and Forms

Document Name Document Type
ManagerPIVScreen.jpg vaww.piv.va.gov/idm/piv Other-VA PIV Enrollment System Porta
SponsorPIVScreen.jpg vaww.piv.va.gov/idm/piv Other-VA PIV Enrollment System Porta
Copy of Entry Page Registrar and Issuer.pdf vaww.piv.va.gov/idm/piv Other-Snap shot

Information Collection (IC) Details

IC Title:	REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-VA PIV Enrollment System Portal	ManagerPIVScreen.jpg	https://vaww.piv.va.gov/idm/piv	Yes	Yes	Fillable Fileable Signable
Other-VA PIV Enrollment System Portal	SponsorPIVScreen.jpg	https://vaww.piv.va.gov/idm/piv	Yes	Yes	Fillable Fileable Signable
Other-Snap shot	Copy of Entry Page Registrar and Issuer.pdf	https://vaww.piv.va.gov/idm/piv	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100,000	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	8,333	8,333
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.