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Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) (VA Form 21P-535)
OMB: 2900-0005
IC ID: 28078
OMB.report
VA
OMB 2900-0005
ICR 201412-2900-012
IC 28078
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0005 can be found here:
2024-05-02 - Revision of a currently approved collection
2022-09-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form VA Form 21P-535
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Form
VA Form 21P-535 Application for Dependency and Indemnity Compensation by
21P-535(12-10-14).pdf
www.va.gov/vaforms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Agency IC Tracking Number:
2900-0005
Is this a Common Form?
No
IC Status:
Modified
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 Form 21P-535
Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation when Applicable)
21P-535(12-10-14).pdf
www.va.gov/vaforms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Survivor Compensation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,600
0
1,817
0
0
1,783
Annual IC Time Burden (Hours)
4,320
0
2,180
0
0
2,140
Annual IC Cost Burden (Dollars)
103,680
0
103,680
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.