APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS

ICR 198410-2900-009

OMB: 2900-0064

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
2900-0064 198410-2900-009
Historical Active 198208-2900-003
VA
APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 11/30/1984
Retrieve Notice of Action (NOA) 10/05/1984
  Inventory as of this Action Requested Previously Approved
09/30/1987 09/30/1987
750 0 0
375 0 0
0 0 0

THE FORM IS FOR THE PURPOSE OF SECURING INFORMATION TO DETERMINE WHETHER THERE ARE AMOUNTS DUE ESTATES OF DECEASED PERSONS WHO HAD BEEN ENTITLED TO BENEFITS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS 21-609

  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 750 0 0 0 750 0
Annual Time Burden (Hours) 375 0 0 0 375 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.
10/05/1984


© 2024 OMB.report | Privacy Policy