Information Collection

Mandatory Verification of Dependents (VA Form 21-0538)

IC 28684 under ICR 202009-2900-017 · OMB 2900-0500.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0500 can be found here:

Documents and Forms

Document Name Document Type
Form 21-0538 Mandatory Verification of Dependents (VA Form 21-0538) Form
21-0538 Mandatory Verification of Dependents VBA-21-0538-ARE.pdf www.va.gov/va.forms Form
21-0538 Mandatory Verification of Dependents VBA-21-0538-ARE.pdf www.va.gov/va.forms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mandatory Verification of Dependents (VA Form 21-0538)	Agency IC Tracking Number:	2900-0500

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.652

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-0538	Mandatory Verification of Dependents	VBA-21-0538-ARE.pdf	www.va.gov/va.forms	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: 85 FR 84119

Number of Respondents: 175,400	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	175,400	-364,600	540,000
Annual IC Time Burden (Hours)	29,233	-60,767	90,000
Annual IC Cost Burden (Dollars)	438,490	-911,478	1,349,968

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.