Information Collection

Status Of Dependents Questionnaire

IC 148329 under ICR 199105-2900-002 · OMB 2900-0500.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0500 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	STATUS OF DEPENDENTS QUESTIONNAIRE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA 21-0538				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 84,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	84,500	53,300	31,200
Annual IC Time Burden (Hours)	14,083	8,883	5,200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.