Information Collection

Application Request to Add and/or Remove Dependents (VA Form 21-686c)

IC 28162 under ICR 202504-2900-004 · OMB 2900-0043.

Documents and Forms

Document Name Document Type
Form VA Form 21-686c Application Request to Add and/or Remove Dependents (VA Form 21-686c) Form
Form VA Form 21-686c Application Request to Add and/or Remove Dependents Application Request to Add and/or Remove Dependents (VA Form 21-686c) Form
VA Form 21-686c Application Request to Add and/or Remove Dependents VAF21-686c, FINAL Copy (3-31-25).pdf www.va.gov/vaforms Form
VA Form 21-686c Application Request to Add and/or Remove Dependents VAF21-686c, FINAL Copy (3-31-25).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application Request to Add and/or Remove Dependents (VA Form 21-686c)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.209 38 CFR 3.205

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21-686c	Application Request to Add and/or Remove Dependents	VAF21-686c, FINAL Copy (3-31-25).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28, Compensation, Pension, Education and Veteran Readiness and Employment Records - VA	FR Citation: 90 FR 20216

Number of Respondents: 535,538	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	535,538	166,376	369,162
Annual IC Time Burden (Hours)	267,769	83,188	184,581
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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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