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

Forms and Documents

Document Name	Status
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
30-DAY FRN (published) 2900-0004.pdf Supplementary Document	2025-07-25
2900-0004 (21P-534, 21P-534a, 21P-534EZ) - Supporting Statement 7-25.docx Supporting Statement A	2025-07-25
60-DAY FRN (published) 2900-0004.pdf Supplementary Document	2025-07-21

IC Document Collections

IC ID	Document Title	Status
232583	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

ICR Details

OMB Control No: 2900-0004	ICR Reference No: 202502-2900-001
Status: Received in OIRA	Previous ICR Reference No: 202209-2900-009
Agency/Subagency: VA	Agency Tracking No: VBA-P&F-KM
Title: 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
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/25/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2025
Responses	111,000	181,588
Time Burden (Hours)	51,800	130,138
Cost Burden (Dollars)	0	0

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Abstract: VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active duty service. The VA Form 21P-534EZ is used for the Fully Developed Claims (FDC) program for pension claims, DIC and accrued claims. Without this information, determination of entitlement would not be possible.

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Authorizing Statute(s): US Code: 38 USC 1542 Name of Law: Children of veterans of a period of war
   US Code: 38 USC 1541 Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
   US Code: 38 USC 5101(a) Name of Law: Claims and forms
   US Code: 38 USC 1151 Name of Law: Benefits for persons disabled by treatment or vocational rehabilitation
   US Code: 38 USC 5121 Name of Law: Payment of certain accrued benefits upon death of a beneficiary
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 21549	05/20/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 34971	07/24/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

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	Application for DIC, Death Pension, and/or Accrued Benefits ,   Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only

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ICR Summary of Burden

	Total Request	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

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The respondent burden has decreased due to the discontinuance of the 21P-534 from this collection.

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Annual Cost to Federal Government: $5,582,673

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/25/2025

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