Supporting Statement - Part A
Application Request to Add and/or Remove Dependents
Control #2900-0043
Summary of Changes from Previously Approved Collection
|
Need for the Information Collection
The Department of Veterans Affairs (VA) through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services, established by law, for veterans, service personnel and their survivors. Information is requested by VA Form 21-686c, Application Request to Add and/or Remove Dependents, under the authority of 38 U.S.C. § 1115, provide that an additional allowance for dependents may be payable to certain veterans and surviving spouses who are entitled to compensation and/or pension benefits. Regulatory authority is found in 38 C.F.R. § 3.205 and 3.209.
Use of the Information
The respondent population for VA Form 21-686c is composed of individuals who may be entitled for an additional allowance for dependents or to remove dependents already established.
As such, this collection of information is used to obtain current information about marital status and dependent child(ren). The information is needed to determine the correct rate of payment for veterans and beneficiaries who may be entitled to an additional allowance for dependents or to remove dependents.
Use of Information Technology
VA Form 21-686c is available on the One-VA Website in a fillable electronic format. VBA is currently hosting this form on a secure server and does not currently have the technology in place to allow for the complete submission of the form. Validation edits are performed to assure data integrity. The collection of information does involve the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology.
Non-Duplication
The information obtained through this collection is unique and is not already available for use or adaptation from another cleared source.
Burden on Small Businesses
This information collection does not impose a significant economic impact on a substantial number of small businesses or entities.
Less Frequent Collection
VA Form 21-686c is used to gather the necessary information to determine eligibility for additional benefits for dependents. Without this information, entitlement to these benefits could not be determined.
Paperwork Reduction Act Guidelines
This collection of information does not require collection to be conducted in a manner inconsistent with the guidelines delineated in 5 CFR 1320.5(d)(2).
Consultation and Public Comments
Part A: PUBLIC NOTICE
A 60-Day Federal Register Notice (FRN) for the collection published on Monday, May 12, 2025. The 60-Day FRN citation is 90 FRN 20216.
No comments were received during the 60-Day Comment Period.
A 30-Day Federal Register Notice for the collection published on Friday, July 18, 2025. The 30-Day FRN citation is 90 FRN 34081.
Part B: CONSULTATION
No additional consultation apart from soliciting public comments through the Federal Register was conducted for this submission.
Gifts or Payment
No payments or gifts are being offered to respondents as an incentive to participate in the collection.
Confidentiality
The records are maintained in the appropriate Privacy Act System of Records identified as “Compensation, Pension, Education, and Veteran Readiness and Employment Records-VA (58VA21/22/28),” published at 74 FR 29275 on June 19, 2009, and last amended at 87 FR 8740 (February 16, 2022).
Sensitive Questions
No questions considered sensitive are being asked in this collection.
Total number of Respondents is estimated at 535,538 per year.
Online portal respondent estimate: 342,075.
Intake center respondent estimate: 193,463.
Frequency of Response is one time.
Annual burden hours are 267,769 hours.
The estimated completion time for this form is 30 minutes.
VA cannot make further assumptions about the population of respondents because of the variability of factors such as the educational background and wage potential of respondents. Therefore, VBA uses general wage data to estimate the respondents’ costs associated with completing the information collection.
The Bureau of Labor Statistics (BLS) gathers information on full-time wage and salary workers. According to the latest available BLS data, the mean hourly wage is $32.66 based on the BLS wage code – “00-0000 All Occupations.” This information was taken from the following website: https://data.bls.gov/oes/#/industry/000000.
Legally, respondents may not pay a person or business for assistance in completing the information collection. Therefore, there are no expected overhead costs for completing the information collection. VBA estimates the total cost to all respondents to be $8,745,335.54 (267,769 burden hours x $32.66 per hour).
Respondent Costs Other Than Burden Hour Costs
There are no annualized costs to respondents other than the labor burden costs addressed in Section 12 of this document to complete this collection.
Costs to the Federal Government
Grade |
Step |
Burden Time |
Fraction of Hour |
Hourly Rate |
Cost Per Response |
Total Responses |
Total |
7 |
3 |
15 |
0.25 |
$21.81 |
5.453 |
535,538 |
$ 2,920,020.95 |
Overhead at 100% Salary |
$ 2,920,020.95 |
||||||
9 |
3 |
10 |
0.17 |
$26.68 |
4.447 |
535,538 |
$ 2,381,358.97 |
Overhead at 100% Salary |
$ 2,381,358.97 |
||||||
11 |
3 |
5 |
0.08 |
$32.28 |
2.690 |
535,538 |
$ 1,440,597.22 |
Overhead at 100% Salary |
$ 1,440,597.22 |
||||||
|
|
||||||
Processing / Analyzing Costs |
$ 13,483,954.28 |
||||||
Printing and Production Cost |
$ 149,821.71 |
||||||
Total Cost to Government |
$ 13,633,775.99 |
Overhead costs are 100% of salary and are the same as the wage listed above and the amounts are included in the total.
Printing and production costs approximates the cost of printing this information collection per year. (Processing/Analyzing Cost total divided by $90).
Note: The hourly wage information above is based on the hourly 2025 General Schedule (Base) Pay (SALARY TABLE 2025-GS). This rate does not include any locality adjustment as applicable.
The processing time estimates above are based on the actual amount of time employees of each grade level spend to process to completion a claim received on this form. The within-grade step (3) of each employee represents the average experience of employees within each grade.
Reason for Change in Burden
The respondent burden has increased due to the estimated number of receivables averaged over the past year.
Publication of Results
The results of this information collection will not be published.
Non-Display of OMB Expiration Date
We are not seeking approval to omit the display of the expiration date of the OMB approval on the collection instrument.
Exceptions to “Certification for Paperwork Reduction Submissions”
We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 2025-07-19 |