Application for Exclusion of Children's Income (21P-0571)

Application for Exclusion of Children's Income (VA Form 21P-0571)

Documents and Forms

Document Name Document Type
Form VA Form 21P-0571 Application for Exclusion of Children's Income (21P-0571) Form
VA Form 21P-0571 Application for Exclusion of Children's Income VBA-21P-0571-ARE.pdf www.va.gov/vaforms Form
VA Form 21P-0571 Application for Exclusion of Children's Income VBA-21P-0571-ARE.pdf www.va.gov/vaforms Form
21P-0571 Application for Exclusion of Children's Income VA Form 21P-0571 - New Burden Statement (508 Conformant 2-13-24) 3-28-24.pdf www.va.gov/vaforms Form
21P-0571 Application for Exclusion of Children's Income VA Form 21P-0571 - New Burden Statement (508 Conformant 2-13-24) 3-28-24.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

IC Title:	Application for Exclusion of Children's Income (21P-0571)	Agency IC Tracking Number:	2900-0510

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.23(d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VA Form 21P-0571	Application for Exclusion of Children's Income	VBA-21P-0571-ARE.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable
Form	21P-0571	Application for Exclusion of Children's Income	VA Form 21P-0571 - New Burden Statement (508 Conformant 2-13-24) 3-28-24.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

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: 84 FR 4138

Number of Respondents: 45	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45	-2,655	2,700
Annual IC Time Burden (Hours)	32	-1,993	2,025
Annual IC Cost Burden (Dollars)	0	0	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.