Information Collection

APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION BY A SURVIVING SPOUSEOR CHILD - IN SERVICE DEATH (VA FORM 21P-534a)

IC 28073 under ICR 201808-2900-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 BY A SURVIVING SPOUSEOR CHILD - IN SERVICE DEATH (VA FORM 21P-534a) Form
21P-534a Application for Dependency and Indemnity Compensation by 2900-0004 21P-534a (1-10-18) OMB Expiring.pdf www.vba.va.gov/pubs/forms/VBA-21P-534a-ARE.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION BY A SURVIVING SPOUSEOR CHILD - IN SERVICE DEATH (VA FORM 21P-534a)	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: 38 CFR 3.5

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	2900-0004 21P-534a (1-10-18) OMB Expiring.pdf	https://www.vba.va.gov/pubs/forms/VBA-21P-534a-ARE.pdf	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: 1,426	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	1,426	-113,574	115,000
Annual IC Time Burden (Hours)	357	-68,734	69,091
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.