Information Collection

Statement of Dependency of Parent(s)

IC 28244 under ICR 201009-2900-021 · OMB 2900-0089.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0089 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-509 Statement of Dependency of Parent(s)	Form
21-509 Statement of Dependency of Parent(s) VA Form 21-509.pdf www.va.gov/vaforms/	Form

IC Title:

Statement of Dependency of Parent(s)

Agency IC Tracking Number:

2900-0089

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.4 38 CFR 3.250

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	21-509	Statement of Dependency of Parent(s)	VA Form 21-509.pdf	http://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: 8,000

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	Previously Approved
Annual Number of Responses for this IC	8,000	8,000
Annual IC Time Burden (Hours)	4,000	4,000
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.