OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans (VA Form 21-0304)

ICR 201407-2900-016 · OMB 2900-0572 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form 21-0304 Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form Modified Repair queued
SuppStmt, VAF 21-0304, 7-29-14.docx Supporting Statement A Uploaded 2014-07-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28777 Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans Form Modified
ICR Details
2900-0572 201407-2900-016
Historical Inactive 201209-2900-014
VA 2900-0572
Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans (VA Form 21-0304)
Revision of a currently approved collection   No
Regular
Withdrawn and continue 08/26/2014
Retrieve Notice of Action (NOA) 07/30/2014
VA has requested to withdraw this information collection request.
  Inventory as of this Action Requested Previously Approved
04/30/2016 36 Months From Approved 06/30/2016
430 0 430
72 0 72
0 0 0
VA Form 21-0304 is used to gather information necessary to determine eligibility for a monetary allowance for a child born with spina bifida or certain birth defects who is a natural child of a Vietnam veteran.
US Code: 38 USC Section 1805 Name of Law: Monetary allowance
   US Code: 38 USC Section 1815 Name of Law: Monetary allowance
  
None
2900-AO81 Proposed rulemaking 78 FR 211 10/31/2013
No
No
No
$4,434
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.
07/30/2014