Information Collection

Application For Dependency And Indemnity Compensation, Death Pension And Accrued Benefits By A Surviving Spouse Or Child, Application For Dic, Survivors Pension, And/or Accrued Benefits, And Applicati

IC 232583 under ICR 202005-2900-017 · 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⚠️ Notice: This information collection may be referencing outdated material.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 VA Form 21P-534 APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD, APPLICATION FOR DIC, SURVIVORS PENSION, AND/OR ACCRUED BENEFITS, AND APPLICATI Form
VA Form 21P-534 Application for Dependency and Indemnity Compensation, S 21P-534(7-23-20).pdf www.va.gov/vaforms Form
VA Form 21P-534EZ Application for DIC, Survivors Pension, and/or Accrued B 21P-534EZ(7-23-20).pdf www.va.gov/vaforms Form
VA Form 21P-534a Application for Dependency and Indemnity Compensation by 21P-534a(7-23-20).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD, APPLICATION FOR DIC, SURVIVORS PENSION, AND/OR ACCRUED BENEFITS, AND APPLICATI	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 38 CFR 3.271

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21P-534	Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)	21P-534(7-23-20).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21P-534EZ	Application for DIC, Survivors Pension, and/or Accrued Benefits	21P-534EZ(7-23-20).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	VA Form 21P-534a	Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only	21P-534a(7-23-20).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: 85 FR 19450

Number of Respondents: 101,426	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	101,426	26,426	75,000
Annual IC Time Burden (Hours)	62,857	31,607	31,250
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.