Information Collection

Mandatory Verification of Dependents (VA Form 21-0538)

IC 28684 under ICR 202309-2900-011 · OMB 2900-0500.

Documents and Forms

Document Name Document Type
Form VA Form 21-0538 Mandatory Verification of Dependents (VA Form 21-0538) Form
VA Form 21-0538 Mandatory Verification of Dependents 21-0538(10-3-23).pdf www.va.gov/vaforms Form
VA Form 21-0538 Mandatory Verification of Dependents 21-0538(10-3-23).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mandatory Verification of Dependents (VA Form 21-0538)	Agency IC Tracking Number:	2900-0500

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.652

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-0538	Mandatory Verification of Dependents	21-0538(10-3-23).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 Veterans Readiness and Employment Records-VA (58VA21/22/28)	FR Citation: 88 FR 22267

Number of Respondents: 123,246	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	123,246	-52,154	175,400
Annual IC Time Burden (Hours)	20,541	-8,692	29,233
Annual IC Cost Burden (Dollars)	0	-438,490	438,490

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.