Information Collection

Applications & Appraisals for Employment for Title 38 Positions and Trainees

IC 28443 under ICR 201904-2900-002 · OMB 2900-0205.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0205 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 10-2850 Applications & Appraisals for Employment for Title 38 Positions and Trainees Form and Instruction
VA Form 10-2850 APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS, OPTOM 10-2850 rev-1.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850-fill.pdf Form and Instruction
VA Form 10-2850C APPLICATION FOR ASSOCIATED HEALTH OCCUPATIONS 10-2850c rev-1.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf Form and Instruction
VA Form 10-2850d Application for Health Professions Trainees 10-2850d Fill (3).pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850d-fill.pdf Form and Instruction
VA FL 10-341(a) Employment Reference for Title 38 Employee VA FL-10-341a-1.pdf vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341a-fill.pdf Form and Instruction
VA FL 10-341(b) Trainee Qualification and Credentials Verification Lette VA FL 10-341b-2.pdf vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341b-fill.pdf Form and Instruction
VA Form 10-2850a APPLICATION FOR NURSES AND NURSE ANESTHETISTS 10-2850a rev-2.pdf vaww.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Applications & Appraisals for Employment for Title 38 Positions and Trainees	Agency IC Tracking Number:	2900-0205

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VA Form 10-2850	APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS, OPTOMETRISTS AND CHIROPRACTORS	10-2850 rev-1.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850C	APPLICATION FOR ASSOCIATED HEALTH OCCUPATIONS	10-2850c rev-1.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850d	Application for Health Professions Trainees	10-2850d Fill (3).pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850d-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA FL 10-341(a)	Employment Reference for Title 38 Employee	VA FL-10-341a-1.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341a-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA FL 10-341(b)	Trainee Qualification and Credentials Verification Letter (TQCVL)	VA FL 10-341b-2.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341b-fill.pdf	Yes	No	Fillable Printable
Form and Instruction	VA Form 10-2850a	APPLICATION FOR NURSES AND NURSE ANESTHETISTS	10-2850a rev-2.pdf	http://vaww.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 386,726	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-386,726	386,726
Annual IC Time Burden (Hours)	-139,016	139,016
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.