35% Exemption Request From 85/15 Reporting Requirement

35% Exemption Request from 85-15 Reporting Requirement (VA Form 22-10216)

Documents and Forms

Document Name Document Type
Form 22-10216 35% EXEMPTION REQUEST FROM 85/15 REPORTING REQUIREMENT Form
22-10216 35% EXEMPTION REQUEST FROM 85/15 REPORTING REQUIREMENT VBA-22-10216-ARE.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	35% EXEMPTION REQUEST FROM 85/15 REPORTING REQUIREMENT	Agency IC Tracking Number:	2900-0896

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 38 CFR 21.4201

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	22-10216	35% EXEMPTION REQUEST FROM 85/15 REPORTING REQUIREMENT	VBA-22-10216-ARE.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: 2,822	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
Annual Number of Responses for this IC	2,822	2,822
Annual IC Time Burden (Hours)	1,411	1,411
Annual IC Cost Burden (Dollars)	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.