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Proposed Information Collection: Income, Net Worth and Employment Statement (in Support of Claim for Total Disability Benefits) and Application for Pension

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Veterans Benefits Administration, Department of Veterans Affairs.


Notice; comment request.


The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed revision of a currently approved collection, and allow 60 days for public comment in response to the notice.


Written comments and recommendations on the proposed collection of information should be received on or before October 6, 2015.


Submit written comments on the collection of information through Federal Docket Management System (FDMS) at or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email to Please refer to Start Printed Page 47564“OMB Control No. 2900-0002” in any correspondence. During the comment period, comments may be viewed online through the FDMS.

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Nancy J. Kessinger at (202) 632-8924 or FAX (202) 632-8925.

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Under the PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501-21), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.

With respect to the following collection of information, VBA invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VBA's functions, including whether the information will have practical utility; (2) the accuracy of VBA's estimate of the burden of the proposed collection of information; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology.

Title: Income, Net Worth and Employment Statement (In Support of Claim for Total Disability Benefits) (21P-527) and Application for Pension (21P-527EZ).

OMB Control Number: 2900-0002.

Type of Review: Revision of a currently approved collection.

Abstract: VA Form 21P-527 is necessary to obtain current employment, dependency, and family income and net worth information entitlement to disability pension. VA disability pension benefits are not payable without this information. VA Form 527EZ is the prescribed form for disability pension claims, respectively, claimed under the Fully Developed Claim (FDC) Program.

Affected Public: Individuals or households.

Estimated Annual Burden: 84,708 hours.

Estimated Average Burden per Respondent: 60 minutes for 21P-527 and 25 minutes for 21P-527EZ.

Frequency of Response: Annually.

Estimated Number of Respondents: 118,197.

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By direction of the Secretary.

Kathleen M. Manwell,

Program Analyst, VA Privacy Service, Office of Privacy and Records Management, Department of Veterans Affairs.

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[FR Doc. 2015-19478 Filed 8-6-15; 8:45 am]