Information Collection

Veteran's Supplemental Claim Application (VA Form 21-526b)

IC 28062 under ICR 201712-2900-005 · OMB 2900-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-526b Veteran's Supplemental Claim Application (VA Form 21-526b)	Form
VA Form 21-526b Veterans Supplemental Claim Application 21-526b(IAI-4-18).pdf www.va.gov/vaforms	Form

IC Title:

Agency IC Tracking Number:

2900-0001

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	VA Form 21-526b	Veterans Supplemental Claim Application	21-526b(IAI-4-18).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 217,178

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	217,178	-216,255	433,433
Annual IC Time Burden (Hours)	54,295	-94,887	149,182
Annual IC Cost Burden (Dollars)	0	0	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.