STATUS OF DEPENDENTS QUESTIONNAIRE

ICR 199105-2900-002

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
148329 Migrated
ICR Details
2900-0500 199105-2900-002
Historical Active 198901-2900-008
VA
STATUS OF DEPENDENTS QUESTIONNAIRE
Revision of a currently approved collection   No
Regular
Approved without change 08/07/1991
Retrieve Notice of Action (NOA) 05/24/1991
  Inventory as of this Action Requested Previously Approved
08/31/1994 08/31/1994 09/30/1991
84,500 0 31,200
14,083 0 5,200
0 0 0

THESE FORMS ARE USED TO REQUEST CERTIFICATION OF THE STATUS OF DEPENDENTS OF VETERANS FOR WHOM ADDITIONAL COMPENSATION IS BEING PAID. THIS INFORMATION IS NECESSARY TO DETERMINE CONTINUED ENTITLEMENT TO THE BENEFITS FOR DEPENDENTS.

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 84,500 31,200 0 53,300 0 0
Annual Time Burden (Hours) 14,083 5,200 0 8,883 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
05/24/1991


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