Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6)

Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (VA Form 21-0960M-6)

Documents and Forms

Document Name Document Type
Form 21-0960M-6 Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6) Form
21-0960M-6 Foot Conditions, Including Flatfoot (Pes Planus) Disabil VA Form 21-0960M-6 (508 Conformant 1-18-17).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (21-0960M-6)	Agency IC Tracking Number:	2900-NEW VBA-COMP-DB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 3.326 38 CFR 3.351

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-0960M-6	Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire	VA Form 21-0960M-6 (508 Conformant 1-18-17).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education, and Rehabilitation RecordsVA (58VA21/22/28)	FR Citation: 75 FR 29275

Number of Respondents: 80,000	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	80,000	80,000
Annual IC Time Burden (Hours)	40,000	40,000
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.