OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Accrued Amounts Due a Deceased Beneficiary (21-601)

ICR 201407-2900-010 · OMB 2900-0216 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 21P-601 Application for Accrued Amounts Due a Deceased Beneficiary Form Modified Available
VA Form 21P-601 Comment Response revised 07.21.15.docx Supplementary Document Uploaded 2015-07-22 Available
2900-0216 Revised Supporting Statement 7.20.15.doc Supplementary Document Uploaded 2015-07-20 Available
30-Day FRN - 2900-0216 (2015).pdf Supplementary Document Uploaded 2015-02-17 Available
60-Day FRN - 2900-0216 (2014).pdf Supplementary Document Uploaded 2015-02-17 Available
201407-2900-010 _VA Form 21P-601 (2-17-15)_2015-03-03 Comments LSW Comments.doc Supporting Statement A Uploaded 2015-07-20 Repair queued
White Paper (2900-0216 - VAF 21P-601) - 7-11-14.docx Supplementary Document Uploaded 2014-07-11 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
28464 Application for Accrued Amounts Due a Deceased Beneficiary Form Modified
ICR Details
2900-0216 201407-2900-010
Historical Active 201406-2900-038
VA 2900-0216 VBA-P&F-YM
Application for Accrued Amounts Due a Deceased Beneficiary (21-601)
Revision of a currently approved collection   No
Regular
Approved without change 08/17/2015
Retrieve Notice of Action (NOA) 02/17/2015
  Inventory as of this Action Requested Previously Approved
11/30/2016 36 Months From Approved 11/30/2016
4,600 0 4,600
2,300 0 2,300
0 0 0
VA Form 21P-601 is used to gather information that is necessary to determine entitlement to accrued benefits, amounts of VA benefits due and unpaid to a deceased beneficiary at the time of death. Benefits are paid to survivors based on the order of preference shown in 38 U.S.C. 5121; however, when there are no eligible survivors, benefits may be paid as reimbursement to the person or persons who bore the expenses of the beneficiary's last illness and burial. Without this information, VA would be unable to properly authorize benefits.
US Code: 38 USC 5121 Name of Law: Payment of certain accrued benefits upon death of a beneficiary
  
None
Not associated with rulemaking
  79 FR 48297 08/15/2014
80 FR 1994 01/14/2015
Yes
1
IC Title Form No. Form Name
Application for Accrued Amounts Due a Deceased Beneficiary 21P-601 Application for Accrued Amounts Due a Deceased Beneficiary
  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 4,600 4,600 0 0 0 0
Annual Time Burden (Hours) 2,300 2,300 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$173,580
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 [email protected]
  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.
02/17/2015