Pre and Post Independent Living Assessment (VA Form 28-0791)

Documents and Forms

Document Name Document Type
Form 28-0791 Pre and Post Independent Living Assessment (VA Form 28-0791) Form and Instruction
28-0791 Pre and Post Independent Living Assessment VBA-28-0791-ARE 6-6-24.pdf www.va.gov/vaforms Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pre and Post Independent Living Assessment (VA Form 28-0791)	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 21.160 38 CFR 21.162 38 CFR 21.50

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	28-0791	Pre and Post Independent Living Assessment	VBA-28-0791-ARE 6-6-24.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education and Veteran Readiness and Employment Records - VA	FR Citation: 87 FR 8740

Number of Respondents: 906	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	906	-1,594	2,500
Annual IC Time Burden (Hours)	906	-1,594	2,500
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.