View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
2900-0793
ICR Reference No:
201306-2900-007
Status:
Historical Active
Previous ICR Reference No:
201211-2900-008
Agency/Subagency:
VA
Agency Tracking No:
Title:
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
12/13/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/03/2013
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2016
36 Months From Approved
Responses
6,500
0
0
Time Burden (Hours)
32,689
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
A collection of information is necessary to implement the Department of Veterans Affairs Visual Impairment and Orientation and Mobility Professionals Scholarship Program and the VA Health Professional Scholarship Program authorized under Public Law 111-163. This legislation allows VA to provide services to the public by awarding scholarships to non-VA employees who will be required to become VA employees in the professions for which they were educated under these programs. These programs will help address VA health care workforce needs.
Authorizing Statute(s):
US Code:
38 USC Part 1, Chapter 5, Section 527
Name of Law: Measurement and Evaluation of DVA Programs
PL:
Pub.L. 111 - 163 302
Name of Law: Caregivers and Veterans Omnibus Health Services act of 2010
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
2900-AO34
Final or interim final rulemaking
78 FR 161
08/20/2013
Federal Register Notices & Comments
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
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr
VA form 10-0491, VA Form 10-0491a, VA Form 10-0491c, VA Form 10-0491d, VA Form 10-0491e, VA Form 10-0491f, VA Form 10-0491g, VA Form 10-0491h, VA Form 10-0491j, VA Form 10-0491i, VA Form 10-0491k, VA Form 10-0491L
HPSP/VIOMPSP Academic Verification
,
HPSP/VIOMPSP Addendum to Application
,
HPSP/VIOMPSP Annual VA employment deferment Verification
,
HPSP/VIOMPSP Education Program Completion Notice_Service Obligation Placement
,
HPSP/VIOMPSP Evaluation Recommendation Form
,
HPSP Agreement
,
HPSP/VIOMPSP Application
,
HPSP/VIOMPSP Notice of Approaching Graduation
,
HPSP/VIOMPSP Notice of Change and/or Annual Academic Status Report
,
HPSP/VIOMPSP Request for Deferment for Advanced Education
,
HPSP/VIOMPSP VA Scholarship Offer Response
,
VIOMPSP Agreement
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
6,500
0
0
6,500
0
0
Annual Time Burden (Hours)
32,689
0
0
32,689
0
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:
This is a new data collection. All burden hours are considered an increase.
Annual Cost to Federal Government:
$4,911,000
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:
09/03/2013
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