Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (Death Compensation..); Application for DIC by a.. (21P-534,534a &534EZ)

Forms and Documents

Document Name	Status
Form VA Form 21P-534 Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a.... Form	Modified
OMB2900-0004(21P-534 534a 534EZ)(12-30-14) (CR 12 30 14) Revised 12.30.14 Second Final Copy.docx Supporting Statement A	2014-12-30

IC Document Collections

IC ID	Document Title	Status
28073	Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a.... Form	Modified

ICR Details

OMB Control No: 2900-0004	ICR Reference No: 201412-2900-020
Status: Historical Inactive	Previous ICR Reference No: 201406-2900-051
Agency/Subagency: VA	Agency Tracking No: VBA-P&F-DB
Title: Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (Death Compensation..); Application for DIC by a.. (21P-534,534a &534EZ)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 03/10/2015
	Date Received in OIRA: 12/30/2014
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	03/31/2015
Responses	145,520	0	145,520
Time Burden (Hours)	87,428	0	87,428
Cost Burden (Dollars)	0	0	0

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Abstract: VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), Survivors Pension, accrued benefits, and death compensation. VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active duty service. The VA Form 21P-534EZ is used by surviving spouses, parents, and children for the Fully Developed Claims (FDC) program for pension and DIC claims.

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Authorizing Statute(s): US Code: 38 USC 1314 Name of Law: Supplemental dependency and indemnity compensation to children
   US Code: 38 USC 1533 Name of Law: Children of Civil War veterans
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
   US Code: 38 USC 1311 Name of Law: Dependency and indemnity compensation to a surviving spouse
   US Code: 38 USC 1312 Name of Law: Benefits in certain cases of in-service or service-connected deaths
   US Code: 38 USC 1313 Name of Law: Dependency and indemnity compensation to children
   US Code: 38 USC 1532 Name of Law: Surviving spouses of Civil War veterans
   US Code: 38 USC 1543 Name of Law: Net worth limitation
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
   US Code: 38 USC 1535 Name of Law: Children of Indian War veterans
   US Code: 38 USC 1536 Name of Law: Surviving spouses of Spanish-American War veterans
   US Code: 38 USC 1537 Name of Law: Children of Spanish-American War veterans
   US Code: 38 USC 1541 Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1534 Name of Law: Surviving spouses of Indian War veterans
   US Code: 38 USC 1542 Name of Law: Children of veterans of a period of war
   US Code: 38 USC 5101 Name of Law: Claims and forms
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AO73	Proposed rulemaking	12 FR 345	12/30/2014

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a....	VA Form 21P-534, VA Form 21P-534a, VA Form 21P- 534EZ	Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child ,   Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only ,   Application for DIC, Death Pension, and/or Accrued Benefits

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Regulations

Short Statement: In RIN 2900-AO73, VA proposes to amend its pension regulations to maintain the integrity of its needs-based pension program. VA has authority under 38 U.S.C. 501(a) to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by VA. VA would amend its information collections consistent with RIN 2900-AO73. This rulemaking is largely in response to a Government Accountability Office (GAO) report, GAO-12-50, Veterans' Pension Benefits: Improvements Needed to Ensure only Qualified Veterans and Survivors Receive Benefits.

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Annual Cost to Federal Government: $10,816,895

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/30/2014

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