OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR DIC OR DEATH PENSION (INCLUDING ACCRUED BENEFITS AND DEATH COMP. WHERE APPLICABLE) FROM THE VA

ICR 197709-2900-004 · OMB 2900-0255 · Historical Active

Forms and Documents
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No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
174599 APPLICATION FOR DIC OR DEATH PENSION (INCLUDING ACCRUED BENEFITS AND DEATH COMP. WHERE APPLICABLE) FROM THE VA Form Migrated
ICR Details
2900-0255 197709-2900-004
Historical Active 197706-2900-007
VA
APPLICATION FOR DIC OR DEATH PENSION (INCLUDING ACCRUED BENEFITS AND DEATH COMP. WHERE APPLICABLE) FROM THE VA
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/16/1977
Approved with change 09/16/1977
Retrieve Notice of Action (NOA) 09/16/1977
  Inventory as of this Action Requested Previously Approved
09/30/1978 09/30/1978 09/30/1978
30,000 0 160,000
5,000 0 40,000
0 0 0

None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR DIC OR DEATH PENSION (INCLUDING ACCRUED BENEFITS AND DEATH COMP. WHERE APPLICABLE) FROM THE VA VA-21-4182
  Total Approved 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 30,000 160,000 0 0 -130,000 0
Annual Time Burden (Hours) 5,000 40,000 0 0 -35,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/16/1977