Information Collection Request
Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966)
ICR 202111-2900-007 · OMB 2900-0826 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0826 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form VA Form 21-0966 Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) |
Form | Modified | Repair queued |
 2023-00590.pdf |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| 2022-24354.pdf |
Supplementary Document | Uploaded 2022-11-08 | Repair queued |
 2900-0826, Supporting Statement (VAF21-0966).docx |
Supporting Statement A | Uploaded 2023-01-11 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 212535 |  Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC (VA Form 21-0966) |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | VA |
| OMB Control No | 2900-0826 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 201801-2900-004 |
| Agency Tracking No | VBA-COMP-NK |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |