Information Collection

Statement of Accredited Representative in Appealed Case

IC 28158 under ICR 201507-2900-003 · OMB 2900-0042.

Documents and Forms

Document Name Document Type
Form 646 Statement of Accredited Representative in Appealed Case Form
646 Statement of Accredited Representative Appealed Case VA Form 646 (Jun 2015).pdf www.va.gov/vaforms/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement of Accredited Representative in Appealed Case	Agency IC Tracking Number:	2900-0042

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 20.600

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	646	Statement of Accredited Representative Appealed Case	VA Form 646 (Jun 2015).pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50,286	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50,286	5,735	44,551
Annual IC Time Burden (Hours)	50,286	5,735	44,551
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.