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:
2900-0004
ICR Reference No:
201406-2900-036
Status:
Historical Active
Previous ICR Reference No:
201107-2900-004
Agency/Subagency:
VA
Agency Tracking No:
2900-0004 VBA-P&F-NK
Title:
Application for Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a... (21-534,534a &534EZ)
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/19/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/19/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2015
01/31/2015
01/31/2015
Responses
63,309
0
63,309
Time Burden (Hours)
76,736
0
76,736
Cost Burden (Dollars)
0
0
0
Abstract:
VA Form 21-534 requests the information necessary to determine entitlement to dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. VA Form 21-534a requests the information necessary to determine entitlement to DIC based on in-service death. Without this collection of information, VA would be unable to authorize and properly pay benefits. VA Form 21-534EZ is used for Fully developed claims.
Authorizing Statute(s):
US Code:
38 USC 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
US Code:
38 USC 1311
Name of Law: Dependency and indemnity compensation to a surviving spouse
US Code:
38 USC 1312
Name of Law: Benefits in certain cases of in-service or service-connected deaths
US Code:
38 USC 1313
Name of Law: Dependency and indemnity compensation to children
US Code:
38 USC 1532
Name of Law: Surviving spouses of Civil War veterans
US Code:
38 USC 1543
Name of Law: Net worth limitation
US Code:
38 USC 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
US Code:
38 USC 1314
Name of Law: Supplemental dependency and indemnity compensation to children
US Code:
38 USC 1533
Name of Law: Children of Civil War veterans
US Code:
38 USC 1534
Name of Law: Surviving spouses of Indian War veterans
US Code:
38 USC 1535
Name of Law: Children of Indian War veterans
US Code:
38 USC 1536
Name of Law: Surviving spouses of Spanish-American War veterans
US Code:
38 USC 1537
Name of Law: Children of Spanish-American War veterans
US Code:
38 USC 1541
Name of Law: Surviving spouses of veterans of a period of war
US Code:
38 USC 1542
Name of Law: Children of veterans of a period of war
US Code:
38 USC 5101
Name of Law: Claims and forms
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
76 FR 142
07/25/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 193
10/05/2011
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 Dependency and Indemnity Compensation (DIC), Death Pension and Accrued Benefits by a Surviving Spouse or Child (death Compensation...); Application for DIC by a....
VA Form 21-534, VA Form 21-534EZ, VA Form 21-534a
Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation If Applicable)
,
Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only
,
Application for DIC, Death Pension, and/or Accrued Benefits
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
63,309
63,309
0
0
0
0
Annual Time Burden (Hours)
76,736
76,736
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
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:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$5,517,096
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:
06/19/2014
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