Information Collection

Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ)

IC 191044 under ICR 202205-2900-006 · OMB 2900-0747.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0747 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ)	Form
VA Form 21-526EZ Application for Disability Compensation and Related Comp VAF21-526EZ, FINAL Draft (9-30-22).pdf www.va.gov/vaforms/	Form
VA Form 21-526EZ Application for Disability Compensation and Related Comp VAF21-526EZ, FINAL Draft (9-30-22).pdf www.va.gov/vaforms/	Form

IC Title:

Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 21-526EZ	Application for Disability Compensation and Related Compensation Benefits	VAF21-526EZ, FINAL Draft (9-30-22).pdf	www.va.gov/vaforms/	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: 58VA21/22/28, Compensation, Pension, Education, and Veteran Readiness and Employment Records - VA

FR Citation: 87 FR 8740

Number of Respondents: 2,015,367

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,015,367	655,367	1,360,000
Annual IC Time Burden (Hours)	587,815	89,148	498,667
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.