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Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation) (VA Form 21P-535)
OMB: 2900-0005
IC ID: 28078
OMB.report
VA
OMB 2900-0005
ICR 202005-2900-012
IC 28078
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0005 can be found here:
2024-05-02 - Revision of a currently approved collection
2022-09-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form VA Form 21P-535
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Form and Instruction
VA Form 21P-535 Application for Dependency and Indemnity Compensation by
21P-535(03-29-2021).pdf
www.vba.va.gov/pubs/forms/VBA-21P-535-ARE.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Agency IC Tracking Number:
2900-0005
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
VA Form 21P-535
Application for Dependency and Indemnity Compensation by Parent(s)(Including Accrued Benefits and Death Compensation when Applicable)
21P-535(03-29-2021).pdf
https://www.vba.va.gov/pubs/forms/VBA-21P-535-ARE.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Survivor Compensation
Privacy Act System of Records
Title:
58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA
FR Citation:
77 FR 42593
Number of Respondents:
3,600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,600
0
0
0
3,600
0
Annual IC Time Burden (Hours)
4,320
0
0
0
4,320
0
Annual IC Cost Burden (Dollars)
103,068
0
0
0
103,068
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.