Statement of Disappearance (VA Form 21P-1775)

OMB 2900-0036

Since no state law providing presumption of death is applicable to VA benefits, VA Form 21P-1775 is needed to gather sufficient information from a claimant so a formal decision can be made regarding the unexplained absence of an individual for over 7 years.

The latest form for Statement of Disappearance (VA Form 21P-1775) expires 2022-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 21P-1775 Statement of Disappearance Form
30-Day FRN - 2900-0036 (2022).pdf Supplementary Document
60-Day FRN (2900-0036).pdf Supplementary Document
2900-0036, Supporting Statement (VAF 21P-1775).docx Supporting Statement A
Statement of Disappearance Form

All Historical Document Collections

202204-2900-014 Approved without change	Extension without change of a currently approved collection	2022-07-11
201902-2900-002 Approved with change	Extension without change of a currently approved collection	2019-07-02
201604-2900-005 Approved without change	Extension without change of a currently approved collection	2016-08-03
201602-2900-043 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-03-17
201305-2900-013 Approved without change	Extension without change of a currently approved collection	2013-09-19
201009-2900-018 Approved without change	Extension without change of a currently approved collection	2011-01-03
200708-2900-024 Approved without change	Extension without change of a currently approved collection	2007-12-06
200411-2900-003 Approved without change	Extension without change of a currently approved collection	2004-11-05
200201-2900-005 Approved without change	Extension without change of a currently approved collection	2002-01-18
199811-2900-016 Approved without change	Reinstatement without change of a previously approved collection	1998-11-23
199508-2900-028 Withdrawn and continue	Extension without change of a currently approved collection	1995-08-28
199310-2900-004 Approved without change	Extension without change of a currently approved collection	1993-10-04
199010-2900-010 Approved without change	Extension without change of a currently approved collection	1990-10-30
198711-2900-010 Approved without change	Extension without change of a currently approved collection	1987-11-23
198410-2900-019 Approved without change	Reinstatement with change of a previously approved collection	1984-10-19
198405-2900-012 Disapproved	Reinstatement without change of a previously approved collection	1984-05-22
198311-2900-009 Approved without change	Extension without change of a currently approved collection	1983-11-25
198012-2900-004 Approved without change	Revision of a currently approved collection	1980-12-08
197601-2900-003 Approved without change	Revision of a currently approved collection	1976-01-14