Veteran's Application for Compensation and/ or Pension; Authorization and Consent to Release Information to the DVA, Veteran's Supplemental Claim Application

Veteran's Application for C&P, Veteran's Supplemental Claim Application, General Release for Med Provider Info to the Dept of VA, Authorization to Disclose Info to the Dept of VA

OMB: 2900-0001

IC ID: 28062

Information Collection (IC) Details

View Information Collection (IC)

Veteran's Application for Compensation and/ or Pension; Authorization and Consent to Release Information to the DVA, Veteran's Supplemental Claim Application 2900-0001
 
Yes Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form VA Form 21-526 Veteran's Application for Compensation and/or Pension VBA-21-526-ARE.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA form 21-526b Veteran's Supplemental Claim For Compensation VBA-21-526b-ARE.pdf www.va.gov/vaforms Yes No Fillable Printable
Form VA Form 21-4142 Authorization to Disclose Information to the Department of Veterans Affairs (VA) 21-4142(7-30-14).pdf www.va/gov/vaforms Yes No Fillable Printable
Form VA Form 21-4142a General Release for Medical Provider Information to the Department of Veterans Affairs (VA) 21-4142a(7-30-14).pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

433,433 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 433,433 0 -290,675 0 0 724,108
Annual IC Time Burden (Hours) 149,182 0 -303,558 0 0 452,740
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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