Information Collection

Application for D.I.C., Survivors Pension, and/or Accrued Benefits (VA Form 21P-534EZ); Application for D.I.C. by a Surviving Spouse or Child-Inservice Death Only (VA Form 21P-534a)

IC 232583 under ICR 202606-2900-008 · OMB 2900-0004.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21p-534a Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only Application for D.I.C., Survivors Pension, and/or Accrued Benefits (VA Form 21P-534EZ); Application for D.I.C. by a Surviving Spouse or Child-Inservice Death Only (VA Form 21P-534a)	Form and Instruction
Form 21P-534ez Application for DIC, Death Pension, and/or Accrued Benefits Application for D.I.C., Survivors Pension, and/or Accrued Benefits (VA Form 21P-534EZ); Application for D.I.C. by a Surviving Spouse or Child-Inservice Death Only (VA Form 21P-534a)	Form and Instruction
21p-534a Application for Dependency and Indemnity Compensation by VBA-21P-534a-ARE.pdf	Form and Instruction
21P-534ez Application for DIC, Death Pension, and/or Accrued Benef 100-Day Initiative 21P-534EZ_New.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Application for D.I.C., Survivors Pension, and/or Accrued Benefits (VA Form 21P-534EZ); Application for D.I.C. by a Surviving Spouse or Child-Inservice Death Only (VA Form 21P-534a)

Agency IC Tracking Number:

2900-0004

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.3 38 CFR 3.5 38 CFR 3.1000

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 and Instruction	21p-534a			www.va.gov/vaforms	Yes	No	Fillable Printable
Form and Instruction	21P-534ez			www.va.gov/vaforms	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

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

FR Citation: 87 FR 8740

Number of Respondents: 110,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	110,000	-1,000	111,000
Annual IC Time Burden (Hours)	45,833	-5,967	51,800
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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