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Get Va 22-8690 1999

OF HOURS 22-8690 CUMULATIVE TO DATE INITIALS STUDENT SUPV. EXISTING STOCKS OF VA FORM 22-8690 JAN 1997 WILL BE USED. U.S. DOD Form dod-va-22-8690 OMB Approval No. 2900-0379 Respondent Burden 5 minutes TIME RECORD WORK-STUDY PROGRAM 3. FILE NUMBER If Ch* 35 include prefix 1. AGREEMENT CONTROL NUMBER 2. NAME OF STUDENT 5. TOTAL NO. OF HOURS TO BE WORKED 4. APPROVED PERIOD OF EMPLOYMENT Month day year A. FROM B. TO INSTRUCTIONS Use Item 8 Remarks on reverse to show changes in Items 6A and 6B. Include effective dates. 6A. PLACE OF EMPLOYMENT 6B. NAME OF SUPERVISOR 6C. MAILING ADDRESS OF SUPERVISOR 6D. TELEPHONE NO. OF SUPERVISOR Include Area Code 7. SCHEDULE OF HOURS WORKED DATE VA FORM JAN 1999 NO. 8. REMARKS PRIVACY ACT INFORMATION No monies or benefits can be paid unless this report is completed and filed as required by existing law and regulations 38 U*S*C. 3485. The information on this form will be used to determine proper amount payable. The responses you submit are considered confidential 38 U*S*C. 5701. They may be disclosed outside VA only if the disclosure is authorized under the Privacy Act including the routine uses identified in the VA system of records 58VA21/22 Compensation Pension Education and Rehabilitation Records - VA published in the Federal Register. The requested information is considered relevant and necessary to determine monies payable under the law. RESPONDENT BURDEN VA may not conduct or sponsor and respondent is not required to respond to this collection of information unless it displays a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 5 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* If you have comments regarding this burden estimate or any other aspect of this collection of information call 1-800-827-1000 for mailing information on where to send your comments. FILE NUMBER If Ch* 35 include prefix 1. AGREEMENT CONTROL NUMBER 2. NAME OF STUDENT 5. TOTAL NO. OF HOURS TO BE WORKED 4. APPROVED PERIOD OF EMPLOYMENT Month day year A. FROM B. TO INSTRUCTIONS Use Item 8 Remarks on reverse to show changes in Items 6A and 6B. APPROVED PERIOD OF EMPLOYMENT Month day year A. FROM B. TO INSTRUCTIONS Use Item 8 Remarks on reverse to show changes in Items 6A and 6B. Include effective dates. 6A. PLACE OF EMPLOYMENT 6B. NAME OF SUPERVISOR 6C. MAILING ADDRESS OF SUPERVISOR 6D. Include effective dates. 6A. PLACE OF EMPLOYMENT 6B. NAME OF SUPERVISOR 6C. MAILING ADDRESS OF SUPERVISOR 6D. TELEPHONE NO. OF SUPERVISOR Include Area Code 7. SCHEDULE OF HOURS WORKED DATE VA FORM JAN 1999 NO. 8. REMARKS PRIVACY ACT INFORMATION No monies or benefits can be paid unless this report is completed and filed as required by existing law and regulations 38 U*S*C. 3485. The information on this form will be used to determine proper amount payable. The responses you submit are considered confidential 38 U*S*C. .

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