APPLICATION FOR AMOUNTS ON DEPOSIT FOR DECEASED VETERAN

ICR 198407-2900-006

OMB: 2900-0133

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
147235 Migrated
ICR Details
2900-0133 198407-2900-006
Historical Active 198107-2900-065
VA
APPLICATION FOR AMOUNTS ON DEPOSIT FOR DECEASED VETERAN
Extension without change of a currently approved collection   No
Regular
Approved without change 09/13/1984
Retrieve Notice of Action (NOA) 07/19/1984
  Inventory as of this Action Requested Previously Approved
08/31/1987 08/31/1987 07/31/1984
700 0 700
175 0 175
0 0 0

VA 21-6898 IS USED TO GATHER THE NECESSARY INFORMATION TO DETERMINE THE PROPER PAYEE OF GRATUITOUS BENEFITS DEPOSITED BY THE VA INTO THE PERSONAL FUNDS OF PATIENTS FOR A VETERAN DURING HOSPITALIZATION AND DU THE VETERAN AT THE DATE OF HIS/HER DEATH.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR AMOUNTS ON DEPOSIT FOR DECEASED VETERAN 21-6898

  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 700 700 0 0 0 0
Annual Time Burden (Hours) 175 175 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.
07/19/1984


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