Information Collection

Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)

IC 28078 under ICR 200810-2900-002 · OMB 2900-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0005 can be found here:

Documents and Forms

Document Name Document Type
Form 21-535 Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) Form
21-535 Application for DIC by Parent(s) (Including Accrued Bene 21-535(4-05).pdf www.va.gov/vaforms/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)	Agency IC Tracking Number:	2900-0005

Is this a Common Form? No		IC Status: Unchanged

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	21-535	Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)	21-535(4-05).pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	4,320	4,320
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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