Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) (VA Form 21P-535)

ICR 201412-2900-012

OMB: 2900-0005

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2015-01-09
Justification for No Material/Nonsubstantive Change
2014-12-29
IC Document Collections
ICR Details
2900-0005 201412-2900-012
Historical Active 201406-2900-053
VA VBA-P&F-NK
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) (VA Form 21P-535)
Revision of a currently approved collection   No
Regular
Approved without change 03/20/2015
Retrieve Notice of Action (NOA) 02/10/2015
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved 03/31/2015
3,600 0 1,783
4,320 0 2,140
103,680 0 0

VA Form 21P-535 is used by surviving parents to apply for Dependency and Indemnity Compensation (DIC), death compensation, and/or accrued benefits. This information collection allows VA to determine eligibility for this benefit.

US Code: 38 USC 5121 Name of Law: Payment of certain accrued benefits upon death of a beneficiary
   US Code: 38 USC 501(a)(2) Name of Law: Rules and regulations
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
   US Code: 38 USC 1315 Name of Law: Dependency and indemnity compensation to parents
   US Code: 38 USC 1121 Name of Law: Death Compensation - Basic entitlement
  
None

Not associated with rulemaking

  79 FR 191 10/02/2014
79 FR 245 12/22/2014
Yes

  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 3,600 1,783 0 1,817 0 0
Annual Time Burden (Hours) 4,320 2,140 0 2,180 0 0
Annual Cost Burden (Dollars) 103,680 0 0 103,680 0 0
Yes
Miscellaneous Actions
No
The requested annual responses is increased to reflect an expected increase in the number of responses. The time burden for the form has not changed, the increase in annual burden hours is caused by the increase in responses. The Annual Cost Burden ($) was not previously calculated, that has been remedied with this submission.

$405,506
No
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 crystal.rennie@va.gov

  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.
02/10/2015


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