Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and....

Court Appointed Fiduciary's Account, Federal Fiduciary's Account, Account Book, Court Appointed Fiduciary's Account, Certificate of Balance on Deposit and Authorization to Disclose Financial Records

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0017 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-4706c Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and.... Form
21P-4706c COURT APPOINTED FIDUCIARY'S ACCOUNT VA Form 21P-4706c (508 Conformant 7-17-19 - OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form
21P-4718a CERTIFICATE OF BALANCE ON DEPOSIT AND AUTHORIZATION TO D VA Form -21P-4718a (508 Conformant 7-30-19 - OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form
21P4706b VA FIDUCIARY'S ACCOUNT VA Form 21P-4706b (OMB Exp. 7-31-19).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Court Appointed Fiduciary's Account (letter size), VA Fiduciary's Account, and Certificate of Balance on Deposit and....	Agency IC Tracking Number:	2900-0017

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 13.200 38 CFR 13.210 38 CFR 13.280

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-4706c	COURT APPOINTED FIDUCIARY'S ACCOUNT	VA Form 21P-4706c (508 Conformant 7-17-19 - OMB Exp. 7-31-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P-4718a	CERTIFICATE OF BALANCE ON DEPOSIT AND AUTHORIZATION TO DISCLOSE FINANCIAL RECORDS	VA Form -21P-4718a (508 Conformant 7-30-19 - OMB Exp. 7-31-19).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P4706b	VA FIDUCIARY'S ACCOUNT	VA Form 21P-4706b (OMB Exp. 7-31-19).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: 33,500	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	33,500	-1,500	35,000
Annual IC Time Burden (Hours)	11,167	-500	11,667
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.