APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION BY SURVIVING SPOUSE OR CHILD (INCLUDING ACCRUED BENEFITS AND DEATH COMPENSATION, WHERE APPLICABLE)
ICR 198208-2900-005 · OMB 2900-0004 · Historical Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0004 can be found here:
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION BY SURVIVING SPOUSE OR CHILD (INCLUDING ACCRUED BENEFITS AND DEATH COMPENSATION, WHERE APPLICABLE)
This information collection request is approved through 9/30/83 on the condition that the following items related to the surviving spouse are deleted: 18 - Date Remarried, 19 - Place Remarried (18 and 19 are duplicative of 20), and 23 - Place of Birth (lack of practical utility Any resubmission for extension should clearly justify the need for items 7, 8, 9, and 10 and explain the practical utility of 11A.
Inventory as of this Action
Requested
Previously Approved
09/30/1983
09/30/1983
08/31/1983
164,500
0
164,500
342,708
0
287,875
0
0
0
VA FORM 21-534 IS AN INITIAL APPLICATION REQUIRED TO FILE A CLAIM FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION BENEFITS BY A SURVIVING SPOUSE AND/OR CHILD/REN. THE INFORMATION REQUIRED IS USED T DETERMINE ELIGIBILITY, DEPENDENCY, DISABILITY AND INCOME DATA, AS APPLICABLE. AUTHORITY IS TITLE 38 U.S.C. CHAPTERS 13 AND 15.
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.
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION BY SURVIVING SPOUSE OR CHILD (INCLUDING ACCRUED BENEFITS AND DEATH COMPENSATION, WHERE APPLICABLE)