View Information Collection Request (ICR) Package

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: 2900-0101	ICR Reference No: 199912-2900-010
Status: Historical Active	Previous ICR Reference No: 199709-2900-007
Agency/Subagency: VA	Agency Tracking No:
Title: Eligibility Verification Reports
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/09/2000
	Date Received in OIRA: 12/30/1999
Terms of Clearance: OMB approves this form for use through 3/31/02 under the following conditions - 1) The VA must immediately incorporate the disclosure statements mandated by the Paperwork Reduction Act of 1995. For the public record, the VA must submit to OMB the revised forms/instructions. 2) The VA must include a detailed description of the reason(s) for an increase in respondent burden in the supporting statement of the next submission. If there are multiple causes for the increase, the VA must include a breakdown of the additional burden resulting from each cause.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2002	05/31/2002	11/30/2000
Responses	293,894	0	709,450
Time Burden (Hours)	146,947	0	354,725
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Eligibility Verification Reports	21-0511S, 21-0511S-1, 21-0511V, 21-0511V-1, 21-0512S, 21-0512S-1, 21-0512V-1, 21-0513, 21-0513-1, 21-0514

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	293,894	709,450	-415,556
Annual Time Burden (Hours)	146,947	354,725	-207,778
Annual Cost Burden (Dollars)	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: Yes

Burden Reduction Due to:

Short Statement:

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.