Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress

Supplemental Information for Change of Program or Re-enrollment After Unsatisfactory Attendance, Conduct or Progress (VA Form 22-8873)

Documents and Forms

Document Name Document Type
Form 22-8873 Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress Form
22-8873 SUPPLEMENTAL INFORMATION FOR CHANGE OF PROGRAM OR REENRO VA Form 22-8873 (508 Conformant 2-19-19).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Supplemental Information for Change of Program or Reenrollment After Unsatisfactory Attendance, Conduct or Progress	Agency IC Tracking Number:	2900-0358

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.5232 38 CFR 21.7614 38 CFR 21.7653 38 CFR 21.4234 38 CFR 21.4277 38 CFR 21.4278 38 CFR 21.7114 38 CFR 21.7153 38 CFR 21.5270

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	22-8873	SUPPLEMENTAL INFORMATION FOR CHANGE OF PROGRAM OR REENROLLMENT AFTER UNSATISFACTORY ATTENDANCE, CONDUCT OR PROGRESS	VA Form 22-8873 (508 Conformant 2-19-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17,720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	17,720	-25,816	43,536
Annual IC Time Burden (Hours)	8,860	-12,909	21,769
Annual IC Cost Burden (Dollars)	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.