This is being returned because it was submitted as a "Request for Common Form" but it is not a common form. The agency may resubmit it as a reinstatement.
Inventory as of this Action
Requested
Previously Approved
08/31/2017
36 Months From Approved
433,433
0
0
149,182
0
0
0
0
0
VA Form 21-526b is used to gather the necessary information to determine a veteran's eligibility, dependency, and income, as applicable, for the compensation and/or pension benefit sought. Without this information, determination of entitlement would not be possible.
The decrease in burden for this control number is because it previously contained four forms. VA Forms 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs, and 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs, have been separated from this control number. A new control number has been assigned for these forms. VA Form 21-526, Veterans Application for Compensation and/or Pension, has been removed due to agency discretion. This form will be discontinued.
VA Forms 21-526b is being revised to include new standardization data points; to include optical character recognition boxes. This is a non-substantive change. The contention questions in Section II of VA Form 21-526b has been revised to match other application forms to stay consistent.
Note: This control number previously contained four forms. VA Forms 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs, and 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs, have been separated from this control number. A new control number has been assigned to these forms. VA Form 21-526, Veterans Application for Compensation and/or Pension, has been removed due to agency discretion. This form will be discontinued.
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
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.
Form VA Form 21-526b Veteran's Supplemental Claim Application (VA Form 21-526b)
2900-0001, Supporting Statement (VAF 21-526b).docx
2017-19987, 30-Day FRN (21-526b).pdf
Veteran's Supplemental Claim Application (VA Form 21-526b)