Information Collection

Request For Substitution Of Claimant Upon Death Of Claimant

IC 189428 under ICR 201806-2900-004 · OMB 2900-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0740 can be found here:

Documents and Forms

Document Name Document Type
Form 21P-0847 REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIMANT Form and Instruction
21P-0847 REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIM VBA-21P-0847-ARE.pdf www.vba.va.gov/pubs/forms/VBA-21P-0847-ARE.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIMANT	Agency IC Tracking Number:

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 and Instruction	21P-0847	REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIMANT	VBA-21P-0847-ARE.pdf	https://www.vba.va.gov/pubs/forms/VBA-21P-0847-ARE.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28, âCompensation, Pension, Education, and Vocational Rehabilitation and Employee RecordsâVAâ	FR Citation: 74 FR 117

Number of Respondents: 20,000	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	20,000	0	20,000
Annual IC Time Burden (Hours)	1,667	0	1,667
Annual IC Cost Burden (Dollars)	0	-41,667	41,667

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.