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:
202005-2900-017
Status:
Historical Active
Previous ICR Reference No:
201808-2900-005
Agency/Subagency:
VA
Agency Tracking No:
VBA-P&F-NK
Title:
Appl. for DIC, Death Pension, and/or Accrued Benefits (21P-534EZ); Appl. for Dependency and Indemnity Compensation by a Surviving Spouse or Child; Appl. for Dependency and Indemnity Compensation
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/12/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/02/2020
Terms of Clearance:
In VA's next extension, revision, or extension request, VA shall ensure that these forms include the information required by 5 CFR 1320.8(b)(3) and shall modify Privacy Act statement such as "Your obligation to respond is required to obtain or retain benefits" to more plain language statements such as "Your response is required to obtain or retain benefits."
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2024
36 Months From Approved
10/31/2021
Responses
101,426
0
101,426
Time Burden (Hours)
62,857
0
62,857
Cost Burden (Dollars)
0
0
0
Abstract:
VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active duty service. The VA Form 21P-534EZ is used for the Fully Developed Claims (FDC) program for pension claims. Without this information, determination of entitlement would not be possible.
Authorizing Statute(s):
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 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
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 1311
Name of Law: Dependency and indemnity compensation to a surviving spouse
US Code:
38 USC 1542
Name of Law: Children of veterans of a period of war
US Code:
38 USC 1541
Name of Law: Surviving spouses of veterans of a period of war
US Code:
38 USC 5101(a)
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:
85 FR 12669
06/12/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 19450
09/03/2020
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION BY A SURVIVING SPOUSEOR CHILD - IN SERVICE DEATH (VA FORM 21P-534a)
21P-534a
Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, DEATH PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD, APPLICATION FOR DIC, SURVIVORS PENSION, AND/OR ACCRUED BENEFITS, AND APPLICATI
VA Form 21P-534, VA Form 21P-534EZ, VA Form 21P-534a
Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)
,
Application for DIC, Survivors Pension, and/or Accrued Benefits
,
Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (Including Death Compensation if Applicable)
21P-534
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (Including Death Compensation if Applicable)
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
101,426
101,426
0
26,426
-26,426
0
Annual Time Burden (Hours)
62,857
62,857
0
31,607
-31,607
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There was no actual burden increase. Each individual form has the same approved burden as the last time it was approved. The only reason it shows in ROCIS as an increase is because the forms are now listed as a bundle versus as individually. We had several forms listed in ROCIS and had to make changes to submit this ICR.
Annual Cost to Federal Government:
$6,881,132
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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?
No
Agency Contact:
Danny Green 202 421-1354 danny.green2@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:
10/02/2020
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