Statement of Dependency of Parent(s)

ICR 200707-2900-018

OMB: 2900-0089

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2007-12-06
IC Document Collections
IC ID
Document
Title
Status
28244 Modified
ICR Details
2900-0089 200707-2900-018
Historical Active 200411-2900-002
VA 2900-0089
Statement of Dependency of Parent(s)
Extension without change of a currently approved collection   No
Regular
Approved without change 01/14/2008
Retrieve Notice of Action (NOA) 12/06/2007
  Inventory as of this Action Requested Previously Approved
01/31/2011 36 Months From Approved 01/31/2008
8,000 0 8,000
4,000 0 4,000
0 0 0

VA Form 21-509 is used to gather income and dependency information from claimants who are seeking payment of benefits as or for a dependent parent. This information is necessary to determine dependency of the parent.

US Code: 38 USC 501(a)(2) Name of Law: Rules and Regulations
   US Code: 38 USC 102 Name of Law: Dependent Parents
  
None

Not associated with rulemaking

  72 FR 152 08/08/2007
72 FR 199 10/16/2007
No

1
IC Title Form No. Form Name
Statement of Dependency of Parent(s) 21-509 Statement of Dependency of Parent(s)

  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 8,000 8,000 0 0 0 0
Annual Time Burden (Hours) 4,000 4,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$167,960
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 [email protected]

  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.
12/06/2007


© 2024 OMB.report | Privacy Policy