Information Collection

Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation where Applicable) from the Department of Veterans Affairs

IC 147790 under ICR 199508-2900-016 · OMB 2900-0255.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0255 can be found here:

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation where Applicable) from the Department of Veterans Affairs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-4182				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14,000	14,000	0
Annual IC Time Burden (Hours)	3,500	0	3,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.