Information Collection

Mandatory Verification of Dependents (VA Form 21-0538)

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VA Form 21-0538 Mandatory Verification of Dependents (VA Form 21-0538)	Form
Form VA Form 21-0538 Mandatory Verification of Dependents Mandatory Verification of Dependents (VA Form 21-0538)	Form
VA Form 21-0538 Mandatory Verification of Dependents 21-0538(10-3-23).pdf	Form
VA Form 21-0538 Mandatory Verification of Dependents 21-0538(10-3-23).pdf	Form

IC Title:

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:

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 21-0538			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 %

table that charts list of burden
	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

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.

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