Information Collection

Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR

IC 28126 under ICR 201011-2900-001 · OMB 2900-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0028 can be found here:

Documents and Forms

Document Name Document Type
Form 3215 Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR Form
3215 Application of Service Representative for Placement on M VA3215.pdf www.va.gov/vaforms Form
3288 Request for and Consent to Release of Information from C VA3288.pdf www.va.gov/vaforms Form
FL 70-2 Request to Correspondent for Identifying Information FL70-2.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application of Service Representaive for Placement on Mailing List, Request for & Consent to Release of Infor. from Claimant's Records, Requests to Correspondent for Identifying Infor., 38 CFR	Agency IC Tracking Number:	2900-0028

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 1.519(A) 38 CFR 1.576(b) 38 CFR 1.526(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form	3215	Application of Service Representative for Placement on Mailing List	VA3215.pdf	http://www.va.gov/vaforms	No	Paper Only
Form	3288	Request for and Consent to Release of Information from Claimant�s Records	VA3288.pdf	http://www.va.gov/vaforms	No	Paper Only
Form	FL 70-2	Request to Correspondent for Identifying Information	FL70-2.pdf	http://www.va.gov/vaforms	No	Paper Only

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 196,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	196,200	196,200
Annual IC Time Burden (Hours)	22,700	22,700
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.