Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ)

Documents and Forms

Document Name Document Type
Form 21-526ez Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ) Form
21-526ez Application for Disability Compensation and Related Comp VBA-21-526EZ-ARE (3).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-526ez	Application for Disability Compensation and Related Compensation Benefits	VBA-21-526EZ-ARE (3).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: 87 FR 8740

Number of Respondents: 2,508,969	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,508,969	493,602	2,015,367
Annual IC Time Burden (Hours)	836,323	248,508	587,815
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.