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Fiduciary Agreement (VA Form 21P-4703)
Fiduciary Agreement (VA Form 21P-4703)
OMB: 2900-0319
IC ID: 28528
OMB.report
VA
OMB 2900-0319
ICR 202401-2900-007
IC 28528
( )
Documents and Forms
Document Name
Document Type
Form 21P-4703
Fiduciary Agreement (VA Form 21P-4703)
Form
21P-4703 Fiduciary Agreement
VA Form 21P-4703 New Burden Statement (508 Conformant 2-12-24) 3-28-24.pdf
www.va.gov/vaforms
Form
21P-4703 Fiduciary Agreement
VA Form 21P-4703 New Burden Statement (508 Conformant 2-12-24) 3-28-24.pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Fiduciary Agreement (VA Form 21P-4703)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
38 CFR 13.140
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
21P-4703
Fiduciary Agreement
VA Form 21P-4703 New Burden Statement (508 Conformant 2-12-24) 3-28-24.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:
58VA21/22/28, Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records - VA
FR Citation:
84 FR 4138
Number of Respondents:
1,331
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
1,331
0
-45,669
0
0
47,000
Annual IC Time Burden (Hours)
110
0
-3,807
0
0
3,917
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.