Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)

Dependent's Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) (VA Form 22-5495)

Documents and Forms

Document Name Document Type
Form 22-5495 Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.) Form
22-5495 Dependents' Request for Change of Program or Place of Tr VA Form 22-5495 (OMB Exp. 2-28-23).pdf www.va.gov/vaforms Form
22-5495 Dependents' Request for Change of Program or Place of Tr VA Form 22-5495 (OMB Exp. 2-28-23).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 21.4234

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	22-5495	Dependents' Request for Change of Program or Place of Training (Under Provisions of Chapter 33 and 35, Title 38 U.S.C.)	VA Form 22-5495 (OMB Exp. 2-28-23).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Compensation, Pension, Education and Veteran Readiness and Employment Records-VA (58VA21/22/28)	FR Citation: 84 FR 4138

Number of Respondents: 45,434	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45,434	-64,326	109,760
Annual IC Time Burden (Hours)	11,358	-16,082	27,440
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.