Information Collection

Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a....

IC 28073 under ICR 201801-2900-002 · OMB 2900-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0004 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-534a Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a.... Form
21P-534a Application for Dependency and Indemnity Compensation by VA Form 21P-534a (1-10-18) OMB Expiring.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a....	Agency IC Tracking Number:	2900-0004

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21P-534a	Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only	VA Form 21P-534a (1-10-18) OMB Expiring.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)	FR Citation: 77 FR 42593

Number of Respondents: 115,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	115,000	-30,520	145,520
Annual IC Time Burden (Hours)	69,091	-18,337	87,428
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.