APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT

ICR 197910-2900-003

OMB: 2900-0027

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0027 197910-2900-003
Historical Active 197208-2900-001
VA
APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 11/05/1979
Retrieve Notice of Action (NOA) 10/11/1979
  Inventory as of this Action Requested Previously Approved
09/30/1984 09/30/1984
3,000 0 0
1,000 0 0
0 0 0

THIS APPLICATION IS REQUIRED TO FILE A CLAIM FOR ACCRUED BENEFITS FOR PRIOR LAW PENSION DUE AT THE VETERAN'S DEATH WHICH WAS WITHHELD DURING HOSPITALIZATION, INSTITUTIONAL OR DOMICILIARY CARE WHEN VA FORM 21-534 OR 21-535 HAS NOT BEEN FILED. THE INFORMATION GATHERED IS NECESSARY TO DETERMINE A 1 PERSONS WHO ARE ELIGIBLE FOR PAYMENT OF THE ACCRUED PAYMENTS AND TO INSURE THAT THE APPROPRIATE CLAIMANT OR CLASS OF CLAIMANTS ARE PAID. AUTHORITY IS 38 U.S.C. 3021

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT 21-551

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 0 0 0 3,000 0
Annual Time Burden (Hours) 1,000 0 0 0 1,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/11/1979


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