APPROVED THROUGH
APRIL 1984. ON OR BEFORE APRIL 30,1984, VA MUST RESUBMIT THE FORM
ACCOMPANIIED BY A SEPARATE JUSTIFICATION FOR EACH ITEM IN SECTION 2
AND "SOCIAL" ITEM IN SECTION 3. OMB CONSIDERS MANY OF THE ITEMS TO
BE UNNCESSARY INTRUSIVE.
Inventory as of this Action
Requested
Previously Approved
04/30/1984
04/30/1984
12/31/1983
2,000
0
2,000
5,500
0
5,500
0
0
0
VA FORM 21-1775 IS REQUIRED TO
ESTABLISH A CLAIM FOR BENEFITS BASED ON THE UNEXPLAINED ABSENCE OF
AN INDIVIDUAL. SICNE NO STATE LAW PROVIDIN FOR PRESUMPTION OF DEATH
IS APPLICABLE TO VA BENEFITS, WE MUST GATHER SUFFICIENT INFORMATION
FROM THE CLAIMANT, ETC., CONCERNING THE DISAPPEARANCE OF THE
INDIVIDUAL TO PROPERLY MAKE A DECISION.
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.