Information Collection

Reports of: General Info., First Notice of Death, Nursing Home or Assisted Living, Defense Finance & Accounting, Non-Receipt of Payment, Incarceration, Month of Death

IC 187592 under ICR 202104-2900-018 · OMB 2900-0734.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0734 can be found here:

2024-12-06 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 27-0820 Reports of: General Info., First Notice of Death, Nursing Home or Assisted Living, Defense Finance & Accounting, Non-Receipt of Payment, Incarceration, Month of Death	Form
VA Form 27-0820 Report of General Information 27-0820(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820 Report of General Information 27-0820(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820a Report of First Notice of Death 27-0820a(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820a Report of First Notice of Death 27-0820a(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820b Report of Nursing Home or Assisted Living Information 27-0820b(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820b Report of Nursing Home or Assisted Living Information 27-0820b(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820c Report of Defense Finance & Accounting Service (DFAS) 27-0820c(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820c Report of Defense Finance & Accounting Service (DFAS) 27-0820c(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820d Report of Non-Receipt of Payment 27-0820d(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820d Report of Non-Receipt of Payment 27-0820d(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820e Report of Incarceration 27-0820e(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820e Report of Incarceration 27-0820e(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820f Report of Month of Death 27-0820f(10-27-21).pdf www.va.gov/vaforms	Form
VA Form 27-0820f Report of Month of Death 27-0820f(10-27-21).pdf www.va.gov/vaforms	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Reports of: General Info., First Notice of Death, Nursing Home or Assisted Living, Defense Finance & Accounting, Non-Receipt of Payment, Incarceration, Month of Death

Agency IC Tracking Number:

2900-0734

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.217

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 27-0820	Report of General Information	27-0820(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820a	Report of First Notice of Death	27-0820a(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820b	Report of Nursing Home or Assisted Living Information	27-0820b(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820c	Report of Defense Finance & Accounting Service (DFAS)	27-0820c(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820d	Report of Non-Receipt of Payment	27-0820d(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820e	Report of Incarceration	27-0820e(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 27-0820f	Report of Month of Death	27-0820f(10-27-21).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: 58VA 21/22/28, Compensation, Pension, Education, Vocational Rehabilitation and Employment Records

FR Citation: 86 FR 20919

Number of Respondents: 2,550,000

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	2,550,000	2,550,000
Annual IC Time Burden (Hours)	212,500	212,500
Annual IC Cost Burden (Dollars)	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.