Information Collection Request

Authorization to Disclose Personal Information to a Third Party (VA Form 21-0845)

ICR 202111-2900-010 · OMB 2900-0736 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0736 can be found here:

Forms and Documents

Document Name	Status
Form 21-0845 Authorization to Disclose Personal Information to a Third Party (VA Form 21-0845) Form	Modified
30-Day FRN - 2900-0736 (2023).pdf Supplementary Document	2023-01-20
2022-24462, 60-Day FRN (VAF21-0845).pdf Supplementary Document	2023-01-12
2900-0736, Supporting Statement (VAF21-0845).docx Supporting Statement A	2023-01-12

IC Document Collections

IC ID	Document Title	Status
188786	Authorization to Disclose Personal Information to a Third Party (VA Form 21-0845) Form	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	VA
OMB Control No	2900-0736
Type of Information Collection	Reinstatement with change of a previously approved collection
Previous ICR Reference No	201903-2900-015
Agency Tracking No	VBA-COMP-YA
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31