Information Collection

Authorization to Substitute a Claim of a Deceased Claimant

IC 189428 under ICR 200906-2900-003 · OMB 2900-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-0847 Request for Substitution of Claimant upon Death of Claimant Authorization to Substitute a Claim of a Deceased Claimant	Form
VA Form 21-0847 Request for Substitution of Claimant upon Death of Claim 21-0847.pdf	Form

IC Title:

Authorization to Substitute a Claim of a Deceased Claimant

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-0847			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	1,667	1,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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