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⚠️ Notice: This information collection may be referencing outdated material.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

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:

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 %

	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

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.