Information Collection

Statement of Person Claiming to Have Stood in Relation of Parent

IC 28190 under ICR 201610-2900-008 · OMB 2900-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21P-524 Statement of Person Claiming to Have Stood in Relation of Parent	Form
21P-524 STATEMENT OF PERSON CLAIMING TO HAVE STOOD IN RELATION O VA Form 21P-524 (508 Compliant 3-9-17).pdf www.va.gov/vaforms	Form

IC Title:

Statement of Person Claiming to Have Stood in Relation of Parent

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 3.59

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-524	STATEMENT OF PERSON CLAIMING TO HAVE STOOD IN RELATION OF PARENT	VA Form 21P-524 (508 Compliant 3-9-17).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 Employment Records - VA

FR Citation: 77 FR 42593

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	400	0	400
Annual IC Time Burden (Hours)	800	0	800
Annual IC Cost Burden (Dollars)	16,180	16,180	0

Documents for IC

table that charts IC Documents
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.