Information Collection

Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

IC 185651 under ICR 202111-2900-009 · OMB 2900-0721.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0721 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)	Form
VA Form 21-2680 Examination for Housebound Status or Permanent Need for 21-2680(1-18-23).pdf www.va.gov/vaforms	Form
VA Form 21-2680 Examination for Housebound Status or Permanent Need for 21-2680(1-18-23).pdf www.va.gov/vaforms	Form

IC Title:

Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

Agency IC Tracking Number:

2900-0721

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.351(d) 38 CFR 3.351(d)(2) 38 CFR 3.351 38 CFR 3.351(c)(2) 38 CFR 4.16 38 CFR 3.326(a)

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 21-2680	Examination for Housebound Status or Permanent Need for Regular Aid and Attendance	21-2680(1-18-23).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 Veteran Readiness and Employment Records-VA (58VA21/22/28)

FR Citation: 87 FR 8740

Number of Respondents: 103,915

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	103,915	89,915	14,000
Annual IC Time Burden (Hours)	51,958	44,958	7,000
Annual IC Cost Burden (Dollars)	0	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.