Request for Details of Expenses

ICR 200109-2900-001

OMB: 2900-0138

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
28359 Migrated
ICR Details
2900-0138 200109-2900-001
Historical Active 199811-2900-009
VA
Request for Details of Expenses
Extension without change of a currently approved collection   No
Regular
Approved without change 11/16/2001
Retrieve Notice of Action (NOA) 09/20/2001
  Inventory as of this Action Requested Previously Approved
11/30/2004 11/30/2004 01/31/2002
22,800 0 22,800
5,700 0 5,700
0 0 0

VA Form 21-8049 is used to obtain the necessary information to determine the amount of any deductible expenses paid by the claimant and/or commercial life insurance received to calculate the appropriate rate of pension benefits.

None
None


No

1
IC Title Form No. Form Name
Request for Details of Expenses 21-8049

  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 22,800 22,800 0 0 0 0
Annual Time Burden (Hours) 5,700 5,700 0 0 0 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.
09/20/2001


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