Income-Net Worth and Employment Statement

ICR 200211-2900-004

OMB: 2900-0002

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
28065 Migrated
ICR Details
2900-0002 200211-2900-004
Historical Inactive 200011-2900-006
VA
Income-Net Worth and Employment Statement
Extension without change of a currently approved collection   No
Regular
Withdrawn and continue 01/07/2003
Retrieve Notice of Action (NOA) 11/08/2002
OMB approval for this collection expires in May 2003. Upon resubmission of this package, VA will address the previous terms of clearance and provide a timeline for adding this form to the VONAPP system. VA will not be requires to publish a Federal Register notice when resubmitting this package for full approval.
  Inventory as of this Action Requested Previously Approved
05/31/2003 05/31/2003 06/30/2003
104,440 0 104,440
104,440 0 0
0 0 0

VA Form 21-527 is used to solicit income, net worth, and employment information. This information is used to determine eligibility and benefit rates for veterans' disability pension and compensation based on individual unemployability.

None
None


No

1
IC Title Form No. Form Name
Income-Net Worth and Employment Statement 21-527

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.
11/08/2002


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