Application For Dependency And Indemnity Compensation Or Death Pension (including Accrued Benefits Where Applicable) From The Department Of Veterans Affairs

APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION (INCLUDING ACCRUED BENEFITS WHERE APPLICABLE) FROM THE DEPARTMENT OF VETERANS AFFAIRS

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0255 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION OR DEATH PENSION (INCLUDING ACCRUED BENEFITS WHERE APPLICABLE) FROM THE DEPARTMENT OF VETERANS AFFAIRS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA-21-4182				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,000	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
Annual Number of Responses for this IC	14,000	14,000
Annual IC Time Burden (Hours)	3,500	3,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.