Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors) (VA Form 21P-8924)

ICR 201708-2900-014

OMB: 2900-0390

Federal Form Document

Forms and Documents
ICR Details
2900-0390 201708-2900-014
Active 201408-2900-014
VA VBA-P&F-DJ/NK
Application of Surviving Spouse or Child for REPS Benefits (Restored Entitlement Program for Survivors) (VA Form 21P-8924)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 03/05/2018
Retrieve Notice of Action (NOA) 01/04/2018
  Inventory as of this Action Requested Previously Approved
03/31/2021 36 Months From Approved
1,800 0 0
600 0 0
14,316 0 0

VA Form 21P-8924 (formerly VA Form 21-8924) is used to gather information that is necessary to determine entitlement of a veteran's surviving spouse or child to REPS benefits.

US Code: 38 USC 5101 Name of Law: Claims and forms
  
None

Not associated with rulemaking

  82 FR 22663 10/19/2017
83 FR 584 01/04/2018
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 1,800 0 0 0 0 1,800
Annual Time Burden (Hours) 600 0 0 0 0 600
Annual Cost Burden (Dollars) 14,316 0 0 14,316 0 0
No
No

$67,386
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.
01/04/2018


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