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Federal forms, ICRs, and supporting documents

Information Collection Request

Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors)

ICR 200205-2900-008 · OMB 2900-0390 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28600 Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors) Form Migrated
ICR Details
2900-0390 200205-2900-008
Historical Active 199904-2900-012
VA
Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors)
Extension without change of a currently approved collection   No
Regular
Approved without change 07/05/2002
Retrieve Notice of Action (NOA) 05/15/2002
  Inventory as of this Action Requested Previously Approved
08/31/2005 08/31/2005 07/31/2002
7,500 0 7,500
2,500 0 2,500
0 0 0
VA Form 21-8924 is used by survivors of deceased veterans to claim REPS benefits. The information on the form is necessary to determine if the applicant meets REPS eligibility criteria.
None
None
No
1
IC Title Form No. Form Name
Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors) 21-8924
  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 7,500 7,500 0 0 0 0
Annual Time Burden (Hours) 2,500 2,500 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.
05/15/2002