Title:Fiduciary Agreement, VA Form 21-4703.
OMB Control Number:2900-0319.
Type of Review:Extension of a currently approved collection.
Abstract:VA Form 21-4703 is a legal binding contract between VA and Federally appointed fiduciaries receiving VA funds on behalf beneficiaries who were determined to be incompetent or under legal disability by reason of minority or court action. The form outlines the fiduciary's responsibility regarding the use of VA funds.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. TheFederal RegisterNotice with a 60-day comment period soliciting comments on this collection of information was published on July 2, 2012, at pages 39345-39346.
Affected Public:Individuals or households.
Estimated Annual Burden:1,467 hours.
Estimated Average Burden per Respondent:5 minutes.
Frequency of Response:One time.
Estimated Number of Respondents:17,600.
By direction of the Secretary.
Dated: September 7, 2012.
Program Analyst, Enterprise Records Service.