OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT

ICR 198406-2900-025 · OMB 2900-0027 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
146600 APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT Form Migrated
ICR Details
2900-0027 198406-2900-025
Historical Active 198107-2900-039
VA
APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT
Revision of a currently approved collection   No
Regular
Approved without change 08/15/1984
Retrieve Notice of Action (NOA) 06/20/1984
  Inventory as of this Action Requested Previously Approved
07/31/1987 07/31/1987 07/31/1984
1,000 0 1,000
333 0 333
0 0 0
VA FORM 21-551 IS USED TO GATHER THE NECESSARY INFORMATION TO DETERMIN A CLAIMANT'S ENTITLEMENT TO ACCRUED BENEFITS WITHHELD DURING THE VETERAN'S HOSPITALIZATION OR DOMICILLIARY CARE.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR ACCRUED BENEFITS BY VETERAN'S WIDOW (WIDOWER), CHILD OR DEPENDENT PARENT 21-551
  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 1,000 1,000 0 0 0 0
Annual Time Burden (Hours) 333 333 0 0 0 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.
06/20/1984