Information Collection

Application for Accrued Amounts Due a Deceased Beneficiary

IC 28464 under ICR 201406-2900-038 · OMB 2900-0216.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0216 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-601 Application for Accrued Amounts Due a Deceased Beneficiary	Form
VA Form 21-601 Application for Accrued Amounts Due a Deceased Beneficia 21-601(DOMA).pdf www.va.gov/vaforms	Form

IC Title:

Application for Accrued Amounts Due a Deceased Beneficiary

Agency IC Tracking Number:

2900-0216 VBA-COMP-YM\\NK

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.1000 38 CFR 3.1001

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 21-601	Application for Accrued Amounts Due a Deceased Beneficiary	21-601(DOMA).pdf	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: 4,600

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	4,600	4,600
Annual IC Time Burden (Hours)	2,300	2,300
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.