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Ankle Conditions Disability Benefits Questionnaire (VA Form 21-0960M-2)
Ankle Conditions Disability Benefits Questionnaire (VA Form 21-0960M-2)
OMB: 2900-0806
IC ID: 206554
OMB.report
VA
OMB 2900-0806
ICR 201711-2900-010
IC 206554
( )
Documents and Forms
Document Name
Document Type
Form VA Form 21-0960M-2
Ankle Conditions Disability Benefits Questionnaire (VA Form 21-0960M-2)
Form
VA Form 21-0960M-2 Ankle Conditions Disability Benefits Questionnaire
VBA-21-0960M-2-ARE.pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ankle Conditions Disability Benefits Questionnaire (VA Form 21-0960M-2)
Agency IC Tracking Number:
VBA-COMP-DJ
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
38 CFR 3.351
38 CFR 3.326
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VA Form 21-0960M-2
Ankle Conditions Disability Benefits Questionnaire
VBA-21-0960M-2-ARE.pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Legislative Functions
Privacy Act System of Records
Title:
Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)
FR Citation:
75 FR 29275
Number of Respondents:
30,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
30,000
0
0
0
30,000
0
Annual IC Time Burden (Hours)
15,000
0
0
0
15,000
0
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.