APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION, AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (INCLUDING DEATH COMPENSATION IF APPLICABLE)

ICR 199309-2900-001

OMB: 2900-0004

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2900-0004 199309-2900-001
Historical Active 199011-2900-006
VA
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION, AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (INCLUDING DEATH COMPENSATION IF APPLICABLE)
Revision of a currently approved collection   No
Regular
Approved without change 12/07/1993
Retrieve Notice of Action (NOA) 09/23/1993
  Inventory as of this Action Requested Previously Approved
12/31/1996 12/31/1996 12/31/1993
66,770 0 162,720
83,462 0 203,400
0 0 0

THIS FORM IS AUTHORIZEE UNDER 38 U.S.C. 1310, 1541, AND 1542 TO GATHER NECESSARY INFORMATION TO DETERMINE A SPOUSES AND/OR CHILD(REN)'S ELIGIBILITY, DEPENDENCY, AND INCOME DATA, AS APPLICABLE, FOR THE BENEF SOUGHT.

None
None


No

  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 66,770 162,720 0 0 -95,950 0
Annual Time Burden (Hours) 83,462 203,400 0 0 -119,938 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.
09/23/1993


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