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Mandatory Verification of Dependents (VA Form 21-0538)
Mandatory Verification of Dependents (VA Form 21-0538)
OMB: 2900-0500
IC ID: 28684
OMB.report
VA
OMB 2900-0500
ICR 202009-2900-017
IC 28684
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0500 can be found here:
2023-12-13 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 21-0538
Mandatory Verification of Dependents (VA Form 21-0538)
Form
21-0538 Mandatory Verification of Dependents
VBA-21-0538-ARE.pdf
www.va.gov/va.forms
Form
21-0538 Mandatory Verification of Dependents
VBA-21-0538-ARE.pdf
www.va.gov/va.forms
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Mandatory Verification of Dependents (VA Form 21-0538)
Agency IC Tracking Number:
2900-0500
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
38 CFR 3.652
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
21-0538
Mandatory Verification of Dependents
VBA-21-0538-ARE.pdf
www.va.gov/va.forms
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Legislative Functions
Privacy Act System of Records
Title:
Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)
FR Citation:
85 FR 84119
Number of Respondents:
175,400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
175,400
0
-364,600
0
0
540,000
Annual IC Time Burden (Hours)
29,233
0
-60,767
0
0
90,000
Annual IC Cost Burden (Dollars)
438,490
0
-911,478
0
0
1,349,968
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.