View Information Collection Request (ICR) Package

OMB Control No: 2900-0846	ICR Reference No: 201908-2900-008
Status: Historical Active	Previous ICR Reference No: 201608-2900-020
Agency/Subagency: VA	Agency Tracking No: 2900-0846
Title: VA-FSC Vendor File Request - Form 10091
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/19/2021
	Date Received in OIRA: 11/12/2020
Terms of Clearance: In its next revision, extension, or reinstatement request, VA shall add to the form a statement of whether confidentiality is being promised and, if so, a specific citation to the authority for promising this confidentiality. In addition, VA shall identify whether any of the respondents are federal employees responding in their capacity as a federal employee. If so, VA shall remove these respondents from its burden estimate, as their responses are not covered by the Paperwork Reduction Act.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved
Responses	150,000	0	0
Time Burden (Hours)	37,500	0	0
Cost Burden (Dollars)	0	0	0

Abstract: The authorizing statute for this data collection falls under 31 USC 3701 and Public Law 104-134, Section 31001, Debt Collection Improvement Act of 1996. The mission of the Nationwide Vendor File Division of the Department of Veterans Affairs – Financial Services Center (VA-FSC) is to add, modify, or delete vendor records in the Financial Management Services (FMS) vendor file. The VA-FSC FMS vendor file controls aspects of when, where, and how vendors are paid. There are currently more than 2.4 million active vendor records in FMS. The VA-FSC Vendor File Request Form, VA Form 10091, was previously created to streamline the data required to establish a vendor record from multiple sources into a single form. The VA now seeks a routine three-year extension of the previous OMB PRA clearance for this form. VA Form 10091 will be used throughout the VA to gather essential payment data from vendors (commercial, individuals, Veterans, employees, etc.) to establish or update vendor records in order to process electronic payments through the ACH network to the vendor's financial institution.

Authorizing Statute(s): US Code: 31 USC 3701 Name of Law: Debt Collection Improvement Act of 1996
PL: Pub.L. 104 - 134 31001 Name of Law: Debt Collection Improvement Act of 1996

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:
	84 FR 53571	10/07/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 22798	04/23/2020
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
FSC Vendor File Request - VA Form 10091	VA Form 10091

ICR Summary of Burden

	Total Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses	150,000	150,000
Annual Time Burden (Hours)	37,500	37,500
Annual Cost Burden (Dollars)	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: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $173,925

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

View ICR - OIRA Conclusion