Statement of Person Claiming to Have Stood in Relation of Parent (VA Form 21P-524)

ICR 201610-2900-008

OMB: 2900-0059

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2017-06-14
Supplementary Document
2017-04-12
Supporting Statement A
2017-06-26
IC Document Collections
ICR Details
2900-0059 201610-2900-008
Historical Active 201307-2900-010
VA VBA-P&F-YA
Statement of Person Claiming to Have Stood in Relation of Parent (VA Form 21P-524)
Extension without change of a currently approved collection   No
Regular
Approved without change 08/08/2017
Retrieve Notice of Action (NOA) 06/26/2017
  Inventory as of this Action Requested Previously Approved
08/31/2020 36 Months From Approved 08/31/2017
400 0 400
800 0 800
16,180 0 0

VA Form 21P-524 is used to gather information from claimants seeking service-connected survivors benefits as persons who stood in relation of parent to deceased veterans. This relationship must be established in order to meet basic eligibility requirements.

US Code: 38 USC 1315 Name of Law: Dependency and indemnity compensation to parents
   US Code: 38 USC 1310 Name of Law: Deaths entitling survivors to dependency and indemnity compensation
  
None

Not associated with rulemaking

  82 FR 8562 01/26/2017
82 FR 27329 06/14/2017
No

1
IC Title Form No. Form Name
Statement of Person Claiming to Have Stood in Relation of Parent 21P-524 STATEMENT OF PERSON CLAIMING TO HAVE STOOD IN RELATION OF PARENT

  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 400 400 0 0 0 0
Annual Time Burden (Hours) 800 800 0 0 0 0
Annual Cost Burden (Dollars) 16,180 0 0 16,180 0 0
No
No

$25,804
No
No
No
No
No
Uncollected
Cynthia Harvey - Pryor 202 461-5870 cynthia.harvey-pryor@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.
06/26/2017


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