APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS

ICR 199010-2900-002

OMB: 2900-0064

Federal Form Document

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Document
Name
Status
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IC Document Collections
ICR Details
2900-0064 199010-2900-002
Historical Active 198709-2900-016
VA
APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS
Extension without change of a currently approved collection   No
Regular
Approved without change 11/21/1990
Retrieve Notice of Action (NOA) 10/01/1990
  Inventory as of this Action Requested Previously Approved
11/30/1993 11/30/1993 12/31/1990
750 0 750
375 0 375
0 0 0

38 CFR 3.1000 PROVIDES AUTHORITY TO GATHER THE NECESSARY INFORMATION FROM THE CLAIMANT TO DETERMINE THE PROPER PAYEE FOR CERTAIN ACCRUED BENEFITS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR AMOUNTS DUE ESTATES OF PERSONS ENTITLED TO BENEFITS 21-609

  Total Approved 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 750 750 0 0 0 0
Annual Time Burden (Hours) 375 375 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
10/01/1990


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