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View ICR - OIRA Conclusion

OMB Control No: 2900-0768	ICR Reference No: 201903-2900-033
Status: Historical Active	Previous ICR Reference No: 201408-2900-016
Agency/Subagency: VA	Agency Tracking No: 2900-0768
Title: Joint Application for Comprehensive Assistance and Support Services for Family Caregivers, VA Form 10-10CG
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/03/2020
	Date Received in OIRA: 01/28/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved
Responses	16,500	0	0
Time Burden (Hours)	4,125	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	16,500	11,500	5,000
Annual Time Burden (Hours)	4,125	2,875	1,250
Annual Cost Burden (Dollars)	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: The prior 5,000 data point was the estimated number of applications anticipated for the initial application. Since that time, the program office has received tens of thousands of applications. Over the past eight (8) years since the program has been in existence, the program office has determined that 16,500 would be a fair estimate of continued future applications.

Annual Cost to Federal Government: $116,500

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? Uncollected

Agency Contact: Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

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