Information Collection

Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

IC 185651 under ICR 202512-2900-001 · OMB 2900-0721.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)	Form
21-2680 Examination for Housebound Status or Permanent Need for VBA-21-2680-ARE 12-3-25.pdf www.va.gov/vaforms	Form

IC Title:

Agency IC Tracking Number:

2900-0721

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.351 38 CFR 3.351(c)(2) 38 CFR 4.16 38 CFR 3.326(a) 38 CFR 3.351(d) 38 CFR 3.351(d)(2)

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	21-2680			www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Compensation, Pension, Education, and Veteran Readiness and Employment Records-VA (58VA21/22/28)

FR Citation: 87 FR 8740

Number of Respondents: 112,587

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	112,587	8,672	103,915
Annual IC Time Burden (Hours)	56,294	4,336	51,958
Annual IC Cost Burden (Dollars)	0	0	0

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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