Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims)

Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims) (VA Form 21-4169)

Documents and Forms

Document Name Document Type
Form 21-4169 Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims) Form
21-4169 Supplement to VA Forms 21-526, 21P-534, and 21P-535 (For VA Form 21-4169 - 508 Conformant (3-17-21).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims)	Agency IC Tracking Number:	2900-0094

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.40

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-4169	Supplement to VA Forms 21-526, 21P-534, and 21P-535 (For Philippine Claims)	VA Form 21-4169 - 508 Conformant (3-17-21).pdf	www.va.gov/vaforms	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: 84 FR 4138

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	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.