Application for Accrued Amounts Due a Deceased Beneficiary, VA Form 21P-601

ICR 201902-2900-004

OMB: 2900-0216

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2019-05-21
Supplementary Document
2019-04-30
Supporting Statement A
2019-05-21
IC Document Collections
ICR Details
2900-0216 201902-2900-004
Active 201601-2900-002
VA VBA-P&F-YA
Application for Accrued Amounts Due a Deceased Beneficiary, VA Form 21P-601
Extension without change of a currently approved collection   No
Regular
Approved with change 09/16/2019
Retrieve Notice of Action (NOA) 06/20/2019
  Inventory as of this Action Requested Previously Approved
09/30/2022 36 Months From Approved 09/30/2019
15,840 0 15,840
7,920 0 7,920
0 0 160,182

VA Form 21P-601 is used to gather the information necessary to determine a claimant’s entitlement to accrued benefits. Accrued benefits are amounts of VA benefits due, but unpaid, to beneficiary at the time of his or her death. Benefits are paid to eligible survivors based on the priority described in 38 U.S.C. §5121(a). When there are no eligible survivors entitled to accrued benefits based on their relationship to the deceased beneficiary, the person or persons who bore the expenses of the beneficiary’s last illness and burial may claim reimbursement for these expenses from accrued amounts.

US Code: 38 USC 5121 Name of Law: Payment of certain accrued benefits upon death of a beneficiary
  
None

Not associated with rulemaking

  84 FR 7183 03/01/2019
84 FR 23167 05/21/2019
No

1
IC Title Form No. Form Name
Application for Accrued Amounts Due a Deceased Beneficiary, VA Form 21P-601 21P-601 APPLICATION FOR ACCRUED AMOUNTS DUE A DECEASED BENEFICIARY

  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 15,840 15,840 0 0 0 0
Annual Time Burden (Hours) 7,920 7,920 0 0 0 0
Annual Cost Burden (Dollars) 0 160,182 0 -160,182 0 0
No
No

$657,043
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.
06/20/2019


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