Authorization to Substitute a Claim of a Deceased Claimant

Request for Substitution of Claimant upon Death of Claimant (21-0847)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0740 can be found here:

Documents and Forms

Document Name Document Type
Form VA Form 21P-0847 Authorization to Substitute a Claim of a Deceased Claimant Form
VA Form 21P-0847 REQUEST FOR SUBSTITUTION OF CLAIMANT UPON VA Form 21P-0847 (9-29-15).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Authorization to Substitute a Claim of a Deceased Claimant	Agency IC Tracking Number:

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-0847	REQUEST FOR SUBSTITUTION OF CLAIMANT UPON	VA Form 21P-0847 (9-29-15).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28, “Compensation, Pension, Education, and Vocational Rehabilitation and Employee Records—VA”	FR Citation: 74 FR 117

Number of Respondents: 20,000	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	20,000	0	20,000
Annual IC Time Burden (Hours)	1,667	0	1,667
Annual IC Cost Burden (Dollars)	41,667	41,667	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.