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: 2900-0165	ICR Reference No: 201911-2900-007
Status: Historical Active	Previous ICR Reference No: 201501-2900-004
Agency/Subagency: VA	Agency Tracking No: 2900-0165
Title: Financial Status Report
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 without change	Conclusion Date: 10/09/2020
	Date Received in OIRA: 06/02/2020
Terms of Clearance: OMB notes that to the extent this form is used by overpayment or debt related to current federal employees arising from their federal employment, that use is not covered by the Paperwork Reduction Act. If VA has appropriate data, it should decrease its burden estimates for that category of use in the next revision, extension, or reinstatement request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved
Responses	116,151	0	0
Time Burden (Hours)	116,151	0	0
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 5 USC 5514 Name of Law: Installment deduction for indebtedness to the United States
   US Code: 38 USC 5302 Name of Law: Waiver of recovery of claims by the United States
   US Code: 38 USC 5314 Name of Law: Indebtedness offsets
   US Code: 31 USC 3711 Name of Law: Collection and compromise
   US Code: 38 USC 3716 Name of Law: Administrative offset
   US Code: 38 USC 3717 Name of Law: Interest and penalty on claims
   US Code: 38 USC 3718 Name of Law: Contracts for collection services
   US Code: 38 USC 5316 Name of Law: Authority to sue to collect certain debts

Citations for New Statutory Requirements: None

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	116,151	20,581	95,570
Annual Time Burden (Hours)	116,151	20,581	95,570
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: More Veterans are using the form to request waiver of collection, setup a payment plan or for the acceptance of a compromise offer on their VA benefit debt.

Annual Cost to Federal Government: $668,794

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: Danny Green 202 421-1354 danny.green2@va.gov

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