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Federal forms, ICRs, and supporting documents

Information Collection Request

Supplement to VA Forms 21-526, 21-534, and 21-535 (For Phillipine Claims)

ICR 199811-2900-017 · OMB 2900-0094 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28257 Supplement to VA Forms 21-526, 21-534, and 21-535 (For Phillipine Claims) Form Migrated
ICR Details
2900-0094 199811-2900-017
Historical Active 199507-2900-002
VA
Supplement to VA Forms 21-526, 21-534, and 21-535 (For Phillipine Claims)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 01/22/1999
Retrieve Notice of Action (NOA) 11/23/1998
Approved for use through 1/2002 under the condition that the VA immediately incorporates the new disclosure statements mandated by the Paperwork Reduction Act of 1995. For the public record, the VA must submit to OMB the revised forms/instructions.
  Inventory as of this Action Requested Previously Approved
02/28/2002 02/28/2002
1,000 0 0
250 0 0
0 0 0
38 U.S.C. 101 and 6104 require VA to ascertain from certain applicants service information, place of residence, evidence held by applicant to prove service, and whether applicant was a member of pro-Japanese, pro-German, or anti-American Filipino organizations. VA form 21-4169 is used to gather the information necessary to make this determination.
None
None
No
1
IC Title Form No. Form Name
Supplement to VA Forms 21-526, 21-534, and 21-535 (For Phillipine Claims) 21-4169
  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 0 0 1,000 0 0
Annual Time Burden (Hours) 250 0 0 250 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
11/23/1998