STATUS OF DEPENDENTS QUESTIONNAIRE

ICR 198901-2900-008

OMB: 2900-0500

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
174757 Migrated
ICR Details
2900-0500 198901-2900-008
Historical Active 198809-2900-008
VA
STATUS OF DEPENDENTS QUESTIONNAIRE
No material or nonsubstantive change to a currently approved collection   No
Emergency 01/05/1989
Approved with change 01/05/1989
Retrieve Notice of Action (NOA) 01/05/1989
  Inventory as of this Action Requested Previously Approved
09/30/1991 09/30/1991 09/30/1991
31,200 0 225,000
5,200 0 37,500
0 0 0

VA FORM 21-0538 IS TO BE USED TO REQUEST TRIENNIAL VERIFICATION OF THE STATUS OF DEPENDENTS OF VETERANS FOR WHOM ADDITIONAL COMPENSATION IS BEING PAID. (38 U.S.C. 210(C)(1). THIS INFORMATION IS NECESSARY TO DETERMINE THEIR CONTINUED ELIGIBILITY FOR SUCH BENEFITS.

None
None


No

1
IC Title Form No. Form Name
STATUS OF DEPENDENTS QUESTIONNAIRE VA 21-0538

  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 31,200 225,000 0 -193,800 0 0
Annual Time Burden (Hours) 5,200 37,500 0 -32,300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
01/05/1989


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