Mandatory Status of Dependents (VA Form 21-0538)

ICR 201709-2900-009

OMB: 2900-0500

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2017-09-20
Supplementary Document
2017-09-20
Supplementary Document
2017-09-20
Supporting Statement A
2017-09-22
IC Document Collections
IC ID
Document
Title
Status
28684 Modified
ICR Details
2900-0500 201709-2900-009
Historical Active 201406-2900-021
VA VBA-COMP-YA
Mandatory Status of Dependents (VA Form 21-0538)
Extension without change of a currently approved collection   No
Regular
Approved without change 12/08/2017
Retrieve Notice of Action (NOA) 09/29/2017
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
84,500 0 84,500
14,083 0 14,083
211,245 0 211,245

VA Form 21-0538 is used to gather information from veterans about the status of dependents for whom additional compensation is being paid. Without this collection of information, VA would be unable to determine continued eligibility for an additional allowance for dependents.

US Code: 38 USC 501 Name of Law: Veteran's Benefits
  
None

Not associated with rulemaking

  82 FR 7917 01/23/2017
82 FR 20687 05/03/2017
No

1
IC Title Form No. Form Name
Mandatory Status of Dependents 21-0538 MANDATORY STATUS OF DEPENDENTS

  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 84,500 84,500 0 0 0 0
Annual Time Burden (Hours) 14,083 14,083 0 0 0 0
Annual Cost Burden (Dollars) 211,245 211,245 0 -336,020 336,020 0
No
No

$3,528,198
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.
09/29/2017


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