View Information Collection (IC)

View Information Collection (IC)

IC Title:	REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIMANT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	21P-0847	REQUEST FOR SUBSTITUTION OF CLAIMANT UPON DEATH OF CLAIMANT	VBA-21P-0847-ARE.pdf	https://www.vba.va.gov/pubs/forms/VBA-21P-0847-ARE.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58VA21/22/28, “Compensation, Pension, Education, and Vocational Rehabilitation and Employee Records—VA”	FR Citation: 74 FR 117

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	20,000	0	0	0	0	20,000
Annual IC Time Burden (Hours)	1,667	0	0	0	0	1,667
Annual IC Cost Burden (Dollars)	0	0	-41,667	0	0	41,667

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.