The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. Information is requested by this form under the authority of:
⢠38 U.S.C. § 1503 Determinations with respect to annual income
⢠38 U.S.C. § 1541 Surviving spouses of veterans of a period of war
⢠38 U.S.C. § 1543 Net worth limitation
⢠38 U.S.C. § 1315 Dependency and indemnity compensation to parents
In RIN 2900-AO73, VA proposes to amend its pension regulations to maintain the integrity of its needs-based pension program. VA has authority under 38 U.S.C. 501(a) to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by VA. VA would amend its information collections in conjunction with RIN 2900-AO73. This rulemaking is largely in response to a Government Accountability Office (GAO) report, GAO-12-50, Veteransâ Pension Benefits: Improvements Needed to Ensure Only Qualified Veterans and Survivors Receive Benefits.
VA Form 21P-0969 will be used by claimants for VA Pension or Parents' Dependency and Indemnity Compensation (DIC) to provide information pertaining to income and assets to establish entitlement to Pension or Parents' DIC. This form will be completed only by those claimants who had income other than Social Security benefits during the calendar year before claiming benefits or who disposed of assets or have significant assets which may affect their entitlement to needs-based benefits.
US Code:
38 USC 1541
Name of Law: Surviving spouses of veterans of a period of war
US Code:
38 USC 1543
Name of Law: Net worth limitation
US Code:
38 USC 1503
Name of Law: Determinations with respect to annual income
US Code:
38 USC 1315
Name of Law: Dependency and indemnity compensation to parents
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 21P-0969 Income and Asset Statement in Support of Claim for
2900-0829 SupportingStatement 20181022.docx
Income and Asset Statement in Support of Claim for