Information Collection

Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)

IC 28078 under ICR 202402-2900-019 · OMB 2900-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21P-535 Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)	Form
Form 21P-535 Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation when Applicable) Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)	Form
21P-535 Application for Dependency and Indemnity Compensation by VA Form 21P-535 - New Burden Statement (OMB Exp. 7-31-24).pdf	Form
21P-535 Application for Dependency and Indemnity Compensation by VA Form 21P-535 - New Burden Statement (OMB Exp. 7-31-24).pdf	Form

IC Title:

Agency IC Tracking Number:

2900-0005

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	21P-535			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records

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

FR Citation: 84 FR 4138

Number of Respondents: 1,000

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	1,000	-2,600	3,600
Annual IC Time Burden (Hours)	1,200	-3,120	4,320
Annual IC Cost Burden (Dollars)	29,760	-73,308	103,068

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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