Exam for Housebound Status or Permanent Need for Regular Aid and Attendance

Exam for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

OMB: 2900-0721

IC ID: 185651

Information Collection (IC) Details

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Exam for Housebound Status or Permanent Need for Regular Aid and Attendance 2900-0721
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 3.351(d) 38 CFR 3.351(d)(2) 38 CFR 3.351(c)(2) 38 CFR 4.16 38 CFR 3.326(a) 38 CFR 3.351

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance VA Form 21-2680 (9-18-14).pdf www.va.gov/vaforms Yes No Fillable Printable

General Government Legislative Functions

 

14,000 0
   
Private Sector Businesses or other for-profits
 
   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 14,000 0 0 0 0 14,000
Annual IC Time Burden (Hours) 7,000 0 0 0 0 7,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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