Information Collection

Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)

IC 28078 under ICR 201412-2900-012 · OMB 2900-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0005 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 21P-535 Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) Form
VA Form 21P-535 Application for Dependency and Indemnity Compensation by 21P-535(12-10-14).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)	Agency IC Tracking Number:	2900-0005

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21P-535	Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation when Applicable)	21P-535(12-10-14).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,600	1,817	1,783
Annual IC Time Burden (Hours)	4,320	2,180	2,140
Annual IC Cost Burden (Dollars)	103,680	103,680	0

Documents for IC

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.