Information Collection

Statement of Dependency of Parent(s) (VA Form 21-509)

IC 28244 under ICR 202402-2900-005 · OMB 2900-0089.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-509 Statement of Dependency of Parent(s) (VA Form 21-509)	Form
Form 21-509 Statement of Dependency of Parent(s) Statement of Dependency of Parent(s) (VA Form 21-509)	Form
21-509 Statement of Dependency of Parent(s) VA Form 21-509 - New Burden Statement (508 Conformant 2-23-24) 3-27-24.pdf	Form
21-509 Statement of Dependency of Parent(s) VA Form 21-509 - New Burden Statement (508 Conformant 2-23-24) 3-27-24.pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0089

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.4 38 CFR 3.250

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	21-509			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: 7,306

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	7,306	-694	8,000
Annual IC Time Burden (Hours)	3,653	-347	4,000
Annual IC Cost Burden (Dollars)	0	-95,440	95,440

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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