Statement of Person Claiming to Have Stood in Relation of Parent (VA Form 21P-524)

ICR 201610-2900-008 · OMB 2900-0059 · Historical Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0059 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form 21P-524 Statement of Person Claiming to Have Stood in Relation of Parent	Form	Modified	Available
30-Day FRN - 2900-0059 (2017).pdf	Supplementary Document	Uploaded 2017-06-14	Available
60-day FRN - 2900-0059 (2017).pdf	Supplementary Document	Uploaded 2017-04-12	Repair queued
2900-0059 Supporting Statement.docx	Supporting Statement A	Uploaded 2017-06-26	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
28190	Statement of Person Claiming to Have Stood in Relation of Parent	Form	Modified

ICR Details

OMB Control No: 2900-0059	ICR Reference No: 201610-2900-008
Status: Historical Active	Previous ICR Reference No: 201307-2900-010
Agency/Subagency: VA	Agency Tracking No: VBA-P&F-YA
Title: Statement of Person Claiming to Have Stood in Relation of Parent (VA Form 21P-524)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/08/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/26/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved	08/31/2017
Responses	400	0	400
Time Burden (Hours)	800	0	800
Cost Burden (Dollars)	16,180	0	0

Abstract: VA Form 21P-524 is used to gather information from claimants seeking service-connected survivors benefits as persons who stood in relation of parent to deceased veterans. This relationship must be established in order to meet basic eligibility requirements.

Authorizing Statute(s): US Code: 38 USC 1315 Name of Law: Dependency and indemnity compensation to parents
US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 8562	01/26/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 27329	06/14/2017
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Statement of Person Claiming to Have Stood in Relation of Parent	21P-524	STATEMENT OF PERSON CLAIMING TO HAVE STOOD IN RELATION OF PARENT

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	400	400	0
Annual Time Burden (Hours)	800	800	0
Annual Cost Burden (Dollars)	16,180	0	16,180

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $25,804

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Cynthia Harvey - Pryor 202 461-5870 [email protected]

Common Form ICR: No