Request for Substitution of Claimant upon Death of Claimant (VA Form 21P-0847)

ICR 202108-2900-010

OMB: 2900-0740

Federal Form Document

IC Document Collections
ICR Details
2900-0740 202108-2900-010
Received in OIRA 201806-2900-004
VA VBA-P&F-YA
Request for Substitution of Claimant upon Death of Claimant (VA Form 21P-0847)
Extension without change of a currently approved collection   No
Regular 10/29/2021
  Requested Previously Approved
36 Months From Approved 11/30/2021
20,000 20,000
1,667 1,667
0 0

VA Form 21P-0847 is used to allow claimants to request substitution for a claimant, who passed away, prior to VA processing a claim to completion. This is only allowed when a claimant dies while a claim or appeal for any benefit under a law administered by the VA is pending. The substitute claimant would be eligible to receive accrued benefits due a deceased claimant under Section 5121(a).

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

Not associated with rulemaking

  86 FR 46095 08/17/2021
86 FR 60110 10/29/2021
No

1
IC Title Form No. Form Name
Request for Substitution of Claimant upon Death of Claimant (VA Form 21P-0847) 21P-0847 Request for Substitution of Claimant upon Death of Claimant

  Total Request 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 20,000 20,000 0 0 0 0
Annual Time Burden (Hours) 1,667 1,667 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$995,135
No
    Yes
    Yes
No
No
No
No
Maribel Aponte 202 266-4688 maribel.aponte@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.
10/29/2021


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