OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Benefits for a Qualifying Veteran's Child Born with Disabilities (VA Form 21-0304)

ICR 202512-2900-009 · OMB 2900-0572 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 21-0304 Application for Benefits for a Qualifying Veteran's Child Born with Disabilities Form Modified Available
Comment-Response2, VAF21-0304 (2900-0572).docx Supplementary Document Uploaded 2026-03-12 Available
VA-2025-VACO-0001-0153.pdf Public Comments Uploaded 2026-03-02 Available
Comment-Response1, VAF21-0304 (2900-0572).docx Supplementary Document Uploaded 2026-03-12 Available
VA-2025-VACO-0001-0146.pdf Public Comments Uploaded 2026-02-02 Available
2026-04818, 30-Day FRN (2900-0572, VAF21-0304).pdf Supplementary Document Uploaded 2026-03-12 Available
2025-23997, 60-Day FRN (VAF21-0304, 2900-0572).pdf Supplementary Document Uploaded 2026-03-04 Available
2900-0572, Supporting Statement (VAF21-0304) 1.docx Supporting Statement A Uploaded 2026-03-13 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28777 Application for Benefits for a Qualifying Veteran's Child Born with Disabilities (VA Form 21-0304) Form ModifiedApplication for Benefits for a Qualifying Veteran's Child Born with Disabilities
28777 Application for Benefits for a Qualifying Veteran's Child Born with Disabilities (VA Form 21-0304) Form Modified
ICR Details
2900-0572 202512-2900-009
Received in OIRA 202211-2900-007
VA VBA-COMP-KM
Application for Benefits for a Qualifying Veteran's Child Born with Disabilities (VA Form 21-0304)
Revision of a currently approved collection   No
Regular 03/13/2026
  Requested Previously Approved
36 Months From Approved 04/30/2026
1,209 688
202 115
0 0
VA Form 21-0304 is used to determine the monetary allowance for a child born with Spina Bifida or certain birth defects who is the natural child of a Vietnam and certain Thailand or Korea service veterans. Without this information, VA would be unable to effectively administer 38 U.S.C. 1805, 1815, 1821, and 1822.
US Code: 38 USC Section 1815 Name of Law: Monetary allowance
   US Code: 38 USC Section 1821 Name of Law: Benefits for Children of Certain Korea Service Veterans Born with Spina Bifida
   US Code: 38 USC Section 1822 Name of Law: Benefits for Children of Certain Thailand Service Veterans Born with Spina Bifida
   US Code: 38 USC Section 1805 Name of Law: Monetary allowance
  
None
Not associated with rulemaking
  90 FR 61224 12/30/2025
91 FR 12280 03/12/2026
Yes
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,209 688 0 521 0 0
Annual Time Burden (Hours) 202 115 0 87 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The respondent burden has increased due to the estimated number of receivables averaged over the past year.
$56,690
No
    Yes
    Yes
No
No
No
No
Dorothy Glasgow 240 205-5190 [email protected]
  No
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.
03/13/2026