OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation Where Applicable) from the Department of Veterans Affairs

ICR 200201-2900-030 · OMB 2900-0255 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28499 Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation Where Applicable) from the Department of Veterans Affairs Form Migrated
ICR Details
2900-0255 200201-2900-030
Historical Inactive 199811-2900-014
VA
Application for Dependency and Indemnity Compensation or Death Pension (Including Accrued Benefits and Death Compensation Where Applicable) from the Department of Veterans Affairs
Extension without change of a currently approved collection   No
Regular
Withdrawn 03/21/2002
Retrieve Notice of Action (NOA) 01/18/2002
Withdrawn consistent with Change Worksheet request submitted to OMB on March 19, 2002. VA is discontinuing this collection.
  Inventory as of this Action Requested Previously Approved
03/31/2002
0 0 14,000
0 0 0
0 0 0
VA Form 21-4182 enables a Social Security applicant to apply for VA benefits at the same time as he or she applies for Social Security benefits.
None
None
No
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