View Information Collection Request (ICR) Package

OMB Control No: 2900-0654	ICR Reference No: 202009-2900-016
Status: Historical Active	Previous ICR Reference No: 201709-2900-011
Agency/Subagency: VA	Agency Tracking No: VBA-COMP-NK
Title: Annual Certification of Veteran Status and Veteran-Relatives (VA Form 20-0344)
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: 06/16/2021
	Date Received in OIRA: 05/13/2021
Terms of Clearance: Approval is granted with the following terms of clearance: 1. The completion of this collection by employees of the Department of Veterans Affairs is not covered by the Paperwork Reduction Act (see 5 CFR 1320.3(c)(3)). VA contractors, however, are covered. It VA's next revision, extension, or reinstatement request, VA shall revise its burden estimate to remove the estimated burden imposed on VA employees, but not that imposed on contractors or non-VA employees. 2. VA shall consider whether this collection is mandatory or required to obtain or retain a benefit (such as access to VA systems/employment, etc.). VA shall then modify the statement on the form to "Your response is mandatory" or "Your response is required to obtain or retain a benefit."

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2024	36 Months From Approved
Responses	14,000	0	0
Time Burden (Hours)	5,834	0	0
Cost Burden (Dollars)	0	0	0

Abstract: VA Form 20-0344 is necessary to ensure that benefit records of employees and employees’ relatives are properly maintained in accordance with VA policy. Without the information provided on this form, VA would be unable to determine which benefit records require special handling to guard against fraud, conflict of interest, improper influence etc. by VA and non-VA employees.

Authorizing Statute(s): US Code: 5 USC 552a (e) (10) Name of Law: Records maintained on individuals

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:
	86 FR 4995	03/10/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 26257	05/13/2021
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
Annual Certification of Veteran Status and Veteran-Relatives (VA Form 20-0344)	VA Form 20-0344

ICR Summary of Burden

	Total Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,000	14,000
Annual Time Burden (Hours)	5,834	5,834
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: $408,458

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: Maribel Aponte 202 266-4688 maribel.aponte@va.gov

View ICR - OIRA Conclusion