View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
2900-0005
ICR Reference No:
201309-2900-007
Status:
Historical Inactive
Previous ICR Reference No:
201107-2900-024
Agency/Subagency:
VA
Agency Tracking No:
2900-0005 VBA-COMP-NK
Title:
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Comment filed on proposed rule and continue
Conclusion Date:
12/13/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/19/2013
Terms of Clearance:
VA will resubmit the information collection at the final rule stage.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2015
36 Months From Approved
03/31/2015
Responses
3,600
0
3,600
Time Burden (Hours)
4,320
0
4,320
Cost Burden (Dollars)
0
0
0
Abstract:
VA Form 21-535 is used by surviving parents to apply for Dependency and Indemnity Compensation (DIC), death compensation, and/or accrued benefits. It would be impossible to determine eligibility for these benefits without this form.
Authorizing Statute(s):
US Code:
38 USC 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
US Code:
38 USC 1315
Name of Law: Dependency and indemnity compensation to parents
US Code:
38 USC 5121
Name of Law: Payment of certain accrued benefits upon death of a beneficiary
US Code:
38 USC 501(a)(2)
Name of Law: Rules and regulations
US Code:
38 USC 1121
Name of Law: Death Compensation - Basic entitlement
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
2900-AO81
Proposed rulemaking
78 FR 211
10/31/2013
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 211
10/31/2013
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
21-535
Application for DIC by Parent(s) (Including Accrued Benefits and Death Compensation)
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Changing Regulations
Short Statement:
There is a change in the annual expected number of respondents due to the Notice of Proposed Rulemaking (NPRM) RIN 2900-AO81, "Standard Claims and Appeals Forms" which proposes to require all claims for benefits to be submitted on an application or form prescribed by the Secretary. VA is proposing to codify its regulations to standardize the use of all VA forms, to include VA Form 21-535. Currently, other than for the initial original claim, VA does not require that claimants submit any subsequent claim on a prescribed VA form. Although there is no substantive change in this form, VA expects a change in the number of respondents submitting VA Form 21-535 on account of VA's electronic claims processing system which will use another form, i.e., VA Form 21-534EZ, that contains the 38 U.S.C. 5103 notices to claimants. VA also expects that more respondents will be filing death benefit claims by parents in the fully developed claim program which requires the use of VA Form 21-534EZ.
Annual Cost to Federal Government:
$215,478
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Crystal Rennie 202 632-7492 crystal.rennie@va.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/19/2013
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