Information Collection Request

Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Available); Application for Dependency and

ICR 202502-2900-001 · OMB 2900-0004 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 21P-534a Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only Form Modified Available
Form 21P-534EZ Application for DIC, Death Pension, and/or Accrued Benefits Form Modified Available
Form 21P-534EZ Appl. for DIC, Death Pension, and/or Accrued Benefits (21P-534EZ); Appl. for Dependency and Indemnity Compensation by a Surviving Spouse or Child; Appl. for Dependency and Indemnity Compensation Form Modified Repair queued
30-DAY FRN (published) 2900-0004.pdf Supplementary Document Uploaded 2025-07-25 Repair queued
30-DAY FRN (published) 2900-0004.pdf Supplementary Document Uploaded 2025-07-25 Repair queued
2900-0004 (21P-534, 21P-534a, 21P-534EZ) - Supporting Statement 7-25.docx Supporting Statement A Uploaded 2025-07-25 Repair queued
2900-0004 (21P-534, 21P-534a, 21P-534EZ) - Supporting Statement 7-25.docx Supporting Statement A Uploaded 2025-07-25 Available
60-DAY FRN (published) 2900-0004.pdf Supplementary Document Uploaded 2025-07-21 Repair queued
60-DAY FRN (published) 2900-0004.pdf Supplementary Document Uploaded 2025-07-21 Repair queued

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2028 36 Months From Approved 08/31/2025
111,000 0 181,588
51,800 0 130,138
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Appl. for DIC, Death Pension, and/or Accrued Benefits (21P-534EZ); Appl. for Dependency and Indemnity Compensation by a Surviving Spouse or Child; Appl. for Dependency and Indemnity Compensation 21P-534EZ, 21P-534a ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 111,000 181,588 0 -70,588 0 0
Annual Time Burden (Hours) 51,800 130,138 0 -78,338 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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