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Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Dependency and Indemnity Compensation by Child

ICR 200201-2900-002 · OMB 2900-0103 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28280 Application for Dependency and Indemnity Compensation by Child Form Migrated
ICR Details
2900-0103 200201-2900-002
Historical Active 199901-2900-002
VA
Application for Dependency and Indemnity Compensation by Child
Extension without change of a currently approved collection   No
Regular
Approved without change 03/21/2002
Retrieve Notice of Action (NOA) 01/18/2002
Approved with revised form faxed to OMB on 3/20/02.
  Inventory as of this Action Requested Previously Approved
03/31/2005 03/31/2005 03/31/2002
7,900 0 7,900
1,975 0 1,975
0 0 0
VA Form 21-4183 is used by a child under age 18 where the surviving spouse was not or is no longer entitled to benefits or by a child age 18 or over regardless of the surviving spouse's entitlement. this form is used in lieu of VA Form 21-534, Application for Dependency and Indemnity Compensation or Death Pension by Widow(er) or Child.
None
None
No
1
IC Title Form No. Form Name
Application for Dependency and Indemnity Compensation by Child VA-21-4183
  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 7,900 7,900 0 0 0 0
Annual Time Burden (Hours) 1,975 1,975 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.
01/18/2002