APPLICATION FOR ACCRUED AMOUNTS OF VETERANS BENEFITS PAYABLE TO WIDOW, WIDOWER, CHILD OR DEPENDENT PARENTS

ICR 198406-2900-010

OMB: 2900-0006

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2900-0006 198406-2900-010
Historical Active 198107-2900-046
VA
APPLICATION FOR ACCRUED AMOUNTS OF VETERANS BENEFITS PAYABLE TO WIDOW, WIDOWER, CHILD OR DEPENDENT PARENTS
Extension without change of a currently approved collection   No
Regular
Approved without change 08/15/1984
Retrieve Notice of Action (NOA) 06/19/1984
  Inventory as of this Action Requested Previously Approved
07/31/1987 07/31/1987 07/31/1984
8,000 0 8,000
4,000 0 4,000
0 0 0

A DEPENDENT WHO HAS NOT FILED FOR DEATH BENEFITS USES VA FORM 21-614 T FILE A CLAIM FOR ACCRUED BENEFITS AVAILABLE AT THE TIME OF THE VETERAN DEATH. THIS FORM IS REQUIRED TO DETERMINE THE APPROPRIATE CLAIMANT OR CLASS OF CLAIMANT ELIGIBLE FOR ACCRUED BENEFITS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR ACCRUED AMOUNTS OF VETERANS BENEFITS PAYABLE TO WIDOW, WIDOWER, CHILD OR DEPENDENT PARENTS 21-614

  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 8,000 8,000 0 0 0 0
Annual Time Burden (Hours) 4,000 4,000 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.
06/19/1984


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