Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims) (VA Form 21-4169)

OMB 2900-0094

OMB 2900-0094

VA Form 21-4169 is used to gather information that is necessary to determine eligibility for benefits based on service in the Commonwealth Army of the Philippines or recognized guerrilla organizations, including service information, proof of service, place of residence, and membership in pro-Japanese, pro-German, or anti-American Filipino organizations. Without this information, VA would be unable to properly authorize benefits. VA Form 21-4169 is being revised to include new standardization data points; to include optical character recognition boxes. This is a non-substantive change.

The latest form for Supplement to VA Forms 21-526EZ, 21P-534EZ, and 21P-535 (For Philippine Claims) (VA Form 21-4169) expires 2021-03-31 and can be found here.

All Historical Document Collections
Approved with change
Revision of a currently approved collection 2024-07-08
Approved without change
Reinstatement without change of a previously approved collection 2021-05-24
Approved without change
Reinstatement without change of a previously approved collection 2018-01-24
Approved without change
Revision of a currently approved collection 2014-09-25
Approved without change
Extension without change of a currently approved collection 2011-08-25
Approved without change
Extension without change of a currently approved collection 2008-07-08
Approved without change
Extension without change of a currently approved collection 2005-06-01
Approved without change
Reinstatement without change of a previously approved collection 2002-05-23
Withdrawn
Reinstatement without change of a previously approved collection 2002-03-15
Approved without change
Reinstatement without change of a previously approved collection 1998-11-23
Approved without change
Extension without change of a currently approved collection 1995-07-14
Approved without change
Extension without change of a currently approved collection 1992-05-28
Approved without change
Revision of a currently approved collection 1989-05-18
Approved without change
Extension without change of a currently approved collection 1986-05-13
Approved without change
Extension without change of a currently approved collection 1983-05-23
Approved without change
Extension without change of a currently approved collection 1978-07-19

© 2024 OMB.report | Privacy Policy