Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)

Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (VA Form 28-1905)

Documents and Forms

Document Name Document Type
Form VA Form 28-1905 Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905) Form
VA Form 28-1905 Authorization and Certification of Entrance or Reentranc 28-1905(2-5-2019).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status (28-1905)	Agency IC Tracking Number:	2900-0014 VBA-VR&E-DB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.332 38 CFR 21.320 38 CFR 21.294 38 CFR 21.321 48 CFR 871.201-2 38 CFR 21.322

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 28-1905	Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status	28-1905(2-5-2019).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: 90,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	90,000	90,000
Annual IC Time Burden (Hours)	7,500	7,500
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.