Income, Asset and Employment Statement and Application for Veterans Pension

Income, Asset and Employment Statement (VA Form 21P-527) and Application for Veterans Pension (VA Form 21P-527EZ)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0002 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-527 Income, Asset and Employment Statement and Application for Veterans Pension Form and Instruction
21P-527 INCOME, NET WORTH, AND EMPLOYMENT STATEMENT 21P-527(7-30-14).pdf www.vba.va.gov/pubs/forms/VBA-21P-527-ARE.pdf Form and Instruction
21P-527EZ Application for Pension 21P-527EZ(7-30-14).pdf www.vba.va.gov/pubs/forms/VBA-21-527EZ-ARE.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Income, Asset and Employment Statement and Application for Veterans Pension	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.340 38 CFR 3.342

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	21P-527	INCOME, NET WORTH, AND EMPLOYMENT STATEMENT	21P-527(7-30-14).pdf	http://www.vba.va.gov/pubs/forms/VBA-21P-527-ARE.pdf	Yes	No	Fillable Printable
Form and Instruction	21P-527EZ	Application for Pension	21P-527EZ(7-30-14).pdf	http://www.vba.va.gov/pubs/forms/VBA-21-527EZ-ARE.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)	FR Citation: 74 FR 29275

Number of Respondents: 118,197	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	118,197	0	118,197
Annual IC Time Burden (Hours)	59,230	0	59,230
Annual IC Cost Burden (Dollars)	1,198,223	1,198,223	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.