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Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Amounts Due Estates of Persons Entitled to Benefits

ICR 200205-2900-018 · OMB 2900-0064 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28201 Application for Amounts Due Estates of Persons Entitled to Benefits Form Migrated
ICR Details
2900-0064 200205-2900-018
Historical Active 199906-2900-007
VA
Application for Amounts Due Estates of Persons Entitled to Benefits
Revision of a currently approved collection   No
Regular
Approved with change 07/24/2002
Retrieve Notice of Action (NOA) 05/24/2002
Approved contingent on VA's use of revised form as submitted on July 22, 2002.
  Inventory as of this Action Requested Previously Approved
07/31/2005 07/31/2005 08/31/2002
750 0 750
375 0 375
0 0 0
VA Form 21-609 is used to gather the necessary information from a claimant to determine the proper payee for certain accrued amounts.
None
None
No
1
IC Title Form No. Form Name
Application for Amounts Due Estates of Persons Entitled to Benefits VA-FORM-21-609
  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 750 750 0 0 0 0
Annual Time Burden (Hours) 375 375 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.
05/24/2002