ANNUAL INCOME QUESTIONNAIRE FOR IMPROVED PENSION AND INSTRUCTIONS FOR COMPLETION

ICR 198107-2900-067

OMB: 2900-0269

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2900-0269 198107-2900-067
Historical Active 198011-2900-034
VA
ANNUAL INCOME QUESTIONNAIRE FOR IMPROVED PENSION AND INSTRUCTIONS FOR COMPLETION
No material or nonsubstantive change to a currently approved collection   No
Emergency 07/17/1981
Approved with change 07/17/1981
Retrieve Notice of Action (NOA) 07/17/1981
  Inventory as of this Action Requested Previously Approved
07/31/1984 07/31/1984 06/30/1985
230,000 0 230,000
76,670 0 76,670
0 0 0

ABSTRACT: THIS FORM IS USED TO FILE THE CLAIMANT'S ANNUAL INCOME REPORT WHEN IN RECEIPT OF IMPROVED PENSION. THE INCOME AND DEPENDENCY DATA FURNISHED IS USED TO DETERMINE THE APPROPRIATE PENSION AWARD TO BE MADE FOR THE FORTHCOMING YEAR. AUTHORITY IS 38 U.S.C. 506.

None
None


No

1
IC Title Form No. Form Name
ANNUAL INCOME QUESTIONNAIRE FOR IMPROVED PENSION AND INSTRUCTIONS FOR COMPLETION 21-8835 &, 21-8835A

  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 230,000 230,000 0 0 0 0
Annual Time Burden (Hours) 76,670 76,670 0 0 0 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.
07/17/1981


© 2024 OMB.report | Privacy Policy