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

ICR 201708-2900-010

OMB: 2900-0005

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2018-02-09
Supplementary Document
2018-02-05
Supplementary Document
2017-12-01
ICR Details
2900-0005 201708-2900-010
Active 201412-2900-012
VA VBA-P&F-NK
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) (VA Form 21P-535)
Extension without change of a currently approved collection   No
Regular
Approved without change 05/15/2018
Retrieve Notice of Action (NOA) 03/09/2018
  Inventory as of this Action Requested Previously Approved
05/31/2021 36 Months From Approved 05/31/2018
3,600 0 3,600
4,320 0 4,320
103,068 0 103,680

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 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
   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
  
None

Deregulatory

Not associated with rulemaking

  82 FR 57029 12/01/2017
83 FR 2215 02/05/2018
No

  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 3,600 0 0 0 0
Annual Time Burden (Hours) 4,320 4,320 0 0 0 0
Annual Cost Burden (Dollars) 103,068 103,680 0 -612 0 0
No
No

$167,544
No
    Yes
    Yes
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.
03/09/2018


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